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. <br /> — <br /> ` , , ��' c � <br /> W.D.Fo�m 4 <br /> CITY OF EVERETT—WATER DEPARTMENT <br /> APPLICATION F(�k WATP'r' <br /> All blanks must be fillcu in or cro��ed out <br /> Evcrett�....._........ .............r::�L..'�._�:..............................19_�':�..`/', <br /> TO THE SUPERIN7'ENDENC,�Y OF EVERETTDEPARTMENT: <br /> I hereby apply tor the use of tvater in accordance witli thc rules and regu- <br /> lations of the Waicr Department, for purposes and tixtures stated b U�rcason <br /> During the lime that ar.y of the �+atcr mains may be taken up Y <br /> o[ any improvements authorized U}' tlic Cily of Everett, in or of any strcet or <br /> alley in which they may have becn lai�.i, lhe City�vill not be required to furnish <br /> �vater durin6 �he propress of suc:i imF��vements to any consumer whose sup- <br /> pIy inay thus be cul off, or be liable for any damages for its failr..•e so to �o. <br /> 1 �- r <br /> Application No..�.,�......J�..-�.-?1....... <br /> � . . ....... Add...................._.. ....___.__... <br /> Block........................................Lot........j�..:.�......:..../.. <br /> /"�.�.. . C l'e!. C ,......Strcet <br /> No...._..................J... � �:...........�-cC.!_at................_.. _: ). <br /> ✓ <br /> ...................................................................................................... <br /> _._..Tlie work 'o Ue executed by................................................................._._Plumbcr <br /> Statc size o[ tap. <br /> _.... ..:.:.::.Tap to bc inscrted in lhe main. <br /> � _.............Nalcr closet ' . � `" �- � ` <br /> ................Bath •' I 1 �"74 � 7: . <br /> . f° <br /> ..:.............Unnal (f' . .'� �:� .. <br /> ................Plain faucet insidc <br /> . .. .._� �.._. <br /> ................Sidc walk washcr � <br /> ................Hosc bib outsidc �;��=�i�,�y.-..�: ;;' <br /> ................Hose Uib for building purposes ✓ <br /> ................Hose Uib inside <br /> IIib tor stnble containing....................stal}i,:..:.............. , , <br /> ......... �, 1. ����� �: .��.lC� �/, �. .�: <br /> ..._...........Numbcr of persons in familY •� G � �l�i Lf <br /> , . t S <br /> ................Numbcr of rooms in bwlding / ' - <br /> The Premises are to be uscd as a..............................i.[.i:cr...:.:._1.=:.:<.�..�:.�.i.... �� . <br /> � <br /> Thc owncr of tl:c Premiscs is........................................................................................ <br /> Thc aEcnt is................................................................. <br /> _................................_............. <br /> This application, altlmu�;h signed, �hall nol�6e bindinS upon the City, until <br /> accapted by lhe Superintert�lent of�tlte �i�ter Ddpartment. . <br /> ' i.�La.'-.:'i� _.��.t�..-.........._..........ApPlicant <br /> Signc�:,,' <br /> t / <br /> .._..1^._.._ By.__..._...._....._._.._..._...._._.__............_..... <br /> Aceepted............................. .._._. SuPerintendent. <br />