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�.-.Q t+-- Y - wx rSn✓ <br />W. D. Form 4-1500--EP.Ca--6-2e-9/ <br />City of Everettr--Water Department <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />1;2 Everett ............. Z..... .....LI.//.....................102...... <br />TO THE SUPERINTENDENT OF THE WA ER DEPA it TAIENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the ru:ee and regu- <br />lations of the Water Department, for purposes and fixtures stated below, <br />During the time that any of the water mains may be taken up by reason <br />of any improvements authorized by the City of Everett, In or of any street or <br />alley In which they may have been laid, the City will not be required to furnish <br />water during the progress of such Improvements to any consumer whose supply <br />may thus be cut off, or be liable for any damages for its failure so to do. <br />Application No.......g0..1................. <br />:-.. .. "t 1.i �. <br />Block....... .. _......... Lotp.�.............r................. Add ... ......... ........... __...... ..... <br />No....N' <br />......2...L.L......��?.a,�f�r.K!t..�.....................Street <br />..... _....... ._ ...... _..... ............._.._............................._..._...__......................... <br />The work to be executed by...... ..... .... ... _..... ...._......_.._..... _...... Plumber <br />State else of tap. <br />--YIO c.....Top to be Inserted In the main. �.�"p <br />....... I ........ Water closet ' U' tF� (I j <br />I ......Bath y� <br />.......`..Urinal <br />.........:'.:.Plain faucet Inside <br />............`..'..Side walk rarher <br />.....:.!�Jlose bib outside <br />................ Hose bib for building purposes <br />........`.......Bose bib Inside <br />......`.......Bib for stable containing....................stall................... <br />......!.......Number of persons in family <br />....7........ Number of roome In building , <br />The premises are to be used as a..._. _./t,f,.h.,-1GC,G,.S� .......................... <br />The owner of the promises Is...�.p.-a;ti,.e--ar'u_.t�_}1� <br />Theagent is ....................... _.................................... <br />... .......... .................. <br />......................... <br />This application, although signed, shall not be binding upon the City, until <br />accepted by the Superintendent of the Water Department. <br />Signed..._ .zza a uou w ..1:PPlicant <br />'... <br />Accepted..,le,',,..;? <br />�- erintendent <br />