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- ::F <br /> i,��. � . � �., <br /> W.D. Form 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> AF�PLICATIOr1 FOR WATER <br /> Ali blanks must he iilled in or crossnd out <br /> Evcrclt�................. .�..-.:.....�......... .............................19_.�''..�.� � <br /> TO THE SUPERINTENDENT OF TF�IE WATER DE;PAA' b1ENT: <br /> CITY OF EVERETT: <br /> I hereby apply tor the use of water in accordance with lhe rules and resu- <br /> la:ions ot the Watcr Department, for purposes and fixtures stated below. <br /> During lhe time that any at the water �r.ains may bc takcn up Uy reason <br /> o! any improvemenls authorized by the Cily of Everett, in or uf any strcet or <br /> alley in which lhcy may have becn laid, lhe City�vill not be required to furnish <br /> waler during lhe P��a6ress of sudt improvements to any consumer whose sup- <br /> ply may thus bc cut off, or bc linblc for any damagns for ils failure so to do. <br /> Application Na�.�.1/_�.............. <br /> Block......................................Lot.....��.�.—. ..��...... Add................_......................... <br /> / /f_...... <br /> No........................L/ f!..;�:.6...:�.�i:�.:F':ti..:t.1��._�C...:.Strect <br /> ..................................................................................................................................................... <br /> . The work to be executed by... ..............................___......................._._....PlumLer <br /> Slatc sizc of tap. <br /> � <br /> ......�.....Tap to bc inserted in lhe main. <br /> 4 <br /> ................Water doset � � <br /> ..'.��...-..:.Aath /'�%i.Z'' ;��/��� �i`s'�.c., <br /> � / / <br /> ................Urinal / / ". . <br /> ................Plain faucet insidc � ,,��,�t;c'<J �/ ��-��� <br /> ...............Side walk washer � �'i,'yS �Q°'O <br /> � ................Hose bib oulside � �_'� '�-�„t� 7-c� <br /> ................Hose bib for building purposes � `�r 1�'."��� t(d 3� <br /> l{��'• ,,,�, <br /> ................Hose bib insidc ...�.4� . ��:.� •'-' �. <br /> ................IIib tor stable containing...................stall....._.......'.:�... � )a 3 "y�. <br /> ' ��:c <br /> ... ...Numbcr of persons in familp <br /> ....�/....Numbcr of rooms in building <br /> The premiscs are lo bc used as a..........................._....___.._ ......__._....__._.._......... <br /> Thc owncr af lhe premises is.........._....._..._..............__..........._.__.___........._.......... <br /> TheaFent is................................._..................._....__......................_........................._... <br /> This application, althaugh siFned, shal] not Ue binding upan th City, until <br /> accepted by the Superintende of �i'aler Deparlm t. . <br /> Signed�...`.�_�......._�L.....��.~-...�.....Applicant <br /> Aceepted....._....................................1E....... By...__...._.............._.................. ...._.............. <br /> Superintc�.denl. <br /> ��'L- _r. <br />