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/� �' � G <br /> W.D.Porm 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLI�CATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> Everett................. ....:f...'.....�..`.?�..............................19_.��..'..� <br /> TO TH.x.' SUPERINTENDENT OF THE WATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> i I:.:��eby apply for the use o[�vater in accordance with the rules and regu- <br /> lalions of the Water Departmenl, for purposes and fixWres stnted below. <br /> During the time that any o[ thc watcr mains may bc taken up by rcason <br /> of any improvemenls authorized by lhe City of Everelt, in or of any strect or <br /> allcy in which they mny hace been laid, the City�vill not Ue required to furnish <br /> walcr during thc progress of such improvements lo any censumer whose sup• �. <br /> ply may thus be cut ott, ar be liaUlc for any damages for its failure so to do. <br /> Application No...._�.�..7..%._�'.......... <br /> Block..............�...y....................... Lot.................._.............../.... Add........................................... <br /> % ��.�._�......_.....Cy-Ci��(.,...c...!!.C_ac...:...........Slrcet <br /> IQo............................ .. <br /> ......................................................................_.............--'--............._............................----......... <br /> The wark to be executed by................._....................._........................._..Plumber <br /> State sizc of tap. <br /> ................Tap to bc inserled in lhe main. <br /> .... Natcr closet � <br /> J ��� ! ;: � c'-��'C <br /> .........1.....Bath S <br /> ......_........Urinal ��b�. �.. ^�Cc �C.� <br /> ................Ylain faucet insidc � �� (�� <br /> ................Sidc walk washer C��. � <br /> ................Hose bib oulside ��`�,_.�, �, . . <br /> ................Hose Uib for buildin�purposes <br /> ................Hose bib insidc <br /> .__...........Bib for slablc containing...................stall............__.... <br /> ....5........Numbcr o[ persons in family <br /> ... y�.......Numbcr of rooms in building <br /> The F'emises arc to Uc used as a..........._............._..........__................._. ......._.__... <br /> Thco�.vn.�r of tha premi�cs is......._.................._................................................_._...... <br /> TheaSent i�.................................................................................................................... <br /> This application, :illh�u�h s' i��d, shall not bc hi aSng upon thc City, until <br /> accepted by tlie SY pciinlen cR f �i�e Waler Depa (nent. <br /> _.�/�d.... . . _.4�:.i�f.v....�'. .:....�`.i:'..�..............ApPlicant <br /> rnE�c <br /> Accepted............................................IP,...... BY.................................................................... <br /> Superintendent. <br />