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/�6,340 5V/ <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 />Everett, ...........................................-;'/ .....�.... .... .......... <br />19..,�J <br />TO THE SUPERINTENDENT 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 Ci'.y of Everett, in or of any street or <br />alley in which they may have been laid, the City will nr4 be required to furnish <br />water during the progress of such improvements to ary consumer whose sup- <br />ply may thus be cut off, or be liable for any damaf;es for its failure so to do. <br />� �- /90 os <br />Application No .... _...... ..._ _.. <br />Block........................................ <br />The work to be executed by ... ................................................ <br />_................... Plumber <br />Slate size of tap. <br />1�.{ ••......Tap to be inserted in the main. <br />...............:Water closet <br />...... �,.... Bath <br />s G. 1''V <br />...... ........ Urinal <br />._....__.....Plain faucet inside <br />1 <br />..__......... Side walk washer <br />t SSU` <br />...... _....... Hose bib outside <br />CRY of Ever ),ca <br />.............. Hose bib for building purposes <br />WATER DEPT• A 3� % 9 <br />... _........... Hose bib inside <br />................Bib for stable containing ..... ............... stall .................... <br />Number of persons in family <br />Number of rooms in building <br />Thepremises are to be used as a ... _...................................... _....................... <br />............ <br />The owner of the premisesIs........................................................................................ <br />Theagent is...................................................................................................................... <br />This application, although signedshall not be bind ing upon the City, until <br />i <br />accepted by the Superintende t of t ater D ao tr t.� <br />....... By. .......... _......... n..................................... _... <br />Superintendent. <br />e <br />