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i <br /> _ � � <br /> W.D. Form 4 <br /> CITY OF EVERETT-WATER DEPARTMENT � <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> FV�rett ...____.... .Y� - � ......._ __ _....19_:�.f. . <br /> � TO THE SUPP:RINTENDENT OF THE WATER DEPARTMENT: ' <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance with the rules 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]aid, the City will not be required to furnish <br /> water during the progress of such impruvements to any consumer whose sup- I <br /> ply may thus be cut off, or be ]iable for any damages for its failure so to do. <br /> Application No_..l.�r.__L�.:'....� <br /> __.....__.. <br /> Block_ ..____ ..__Lot ... . 3� ._. <br /> J F ) __..._.. <br /> .... _ .... A ...._. <br /> No_. _ ..�. f �J �l�c ��._..!/a -e� �� � �_�.._Street � <br /> _.__ ...._.___ ..__....... ._..._.. _ ........ __....._ .:...._._.._._. � <br /> The work to be executed by ._..._ _ ....__ _. ..._. _..Plumber <br /> Sjate size of tap. <br /> -..:,:�./.....,_Tap to be inserted in the main. <br /> �-.� ./....JWater closet <br /> �--`.�.��ath �4_..�� l<<.�•--��: <br /> i � <br /> --..__-.---.Urinal _ ���a-u��°�—^ (�� <br /> ..._.._.._.Plain faucet inside � S�'�A �D- - :t <br /> � �.: <br /> _._..._._._Side walk washer ' � �� �af� �� <br /> .._.Hose bib outside �' ��Ir� �� ' �1 �� <br /> .�-___ .....Hose bib for building purposes �� �' 1 � � ' g� `' � <br /> `� � <br /> ...._.___..Hose bib inside . � . � <br /> ._.._._....._Bib for stabie containing.....___..._..stall._..___._._. . <br /> ....._.._...._Number of persons in family <br /> --�._..Number of rooms in building <br /> . The premises are to be used as a___. _....... _._.___. ......_._.._. <br /> The owner of the premises is..........._.. ..........._.._ ..........._ ...__........_... <br /> TSe agent is _.___... ._. <br /> . _._._ ......__._..... .._._...._...._.__._._......._. <br /> This application, although signed, shall not be bindin upon the City, unti] <br /> accepted by the Superintendent of the Water D�partm . <br /> -�--j��,,�`,/�. <br /> Signed .._._ . .. t�1,�...--..._.Applicant <br /> Accepted .._..._. _,._...__..1°'_.... By_..__._..._ _ <br /> __.._.. .___..._.. <br /> SuPerintendent. <br />