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� �� /i ._c' . �: , - <br /> W.D. Fo�m 4 <br /> CITY OF EV�RETT-WATER DEPARTMENT <br /> � APPLICATION FOR WATER <br /> All blanks must 6c filled in or crossed aut <br /> Evcrett................. L%"......:.�._C:. 19�:.5! <br /> TO THE SUPERINTENDENCITY OF F.VERETI'DEPARTDIENT: <br /> I hereby applY for the use of waler in accorda�ce wilh the rules and mgu- <br /> lalions o[ thc Naler Department, for Purposes and fixtures stated Uclow. <br /> During thc time lhat any at tnc water mains may bc taken up Uy rmson <br /> of any improvements authorized by the Cily of Evcrett, m ar of any strect or <br /> alley in wh�cL• thcy may havc bcen laid, the City will not bc required to furnish <br /> waler during the pragress of snch improvements to any consumer whose sup- <br /> ply may thus be cut otf, or Ue IiaUle for any damages for ils failure so to do. <br /> ppplication No...�.Gs��,.)" �....��.. ` <br /> ..... .. <br /> . Lat.............`:'....� . Add........................... ..._.......... <br /> Block....................................... 7........... <br /> ,� � /.� �: -J , , <br /> xo............... .... .... ... ........... ....«c;.l..:l.:i:t_.�.e...... �c..�..sercci <br /> s .................................................................................................................................. <br /> Thc tvork to Ue executed bY..............--.......-..-......................`................Plumber <br /> Statc sizc of tap. <br /> � _��....Tap to be inserlcd in lhe main. <br /> .�..........Watcr claset ;� �� <<�� <br /> ................Bath �1� � , <br /> . ...........Urinal J�A � �4 � �` `, <br /> ,� ; <br /> ... .....Plain faucet insidc � -� ,,/� <br /> ! � <br /> C /• <br /> ................Sidc walk washer . <br /> ,. ................Hose bib oulside , � <br /> ................Aose bib for building purposes ' <br /> ................Iiose bib insidc <br /> ................Bib for slablc containing............._..._stalL................... <br /> ................Number of person, in family <br /> � _..............Numbcr of rooms in buildin�; <br /> The premises arc to Uc used as a......... . ---��---�-�- �- - �-�- --�� - -��- <br /> . ._...__._____... <br /> The owner af thc Premises is.................._....................................__......__.............._.. <br /> The agent is.............................. ......................... <br /> ........................................................... <br /> This application, altltnu„ signed, shall not be binding upon the City, until <br /> :iccef:'cd by the uperinlend t of lhe Water Depart . <br /> � ned........... ..... .........�^.......�J.....�APPlicant <br /> ......... /� <br /> � � . ... II.v._......_.. _. . . ..._.. .. . .._... <br /> t Acccp;cu._.. ._. .. ._....._. .:...,l�.. . ......_..Supci mlondenl. <br />