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�� <br />:�'.�' ��'�'LnI(k�'AM$ R' ..-. ._ ... ' . . . . . W. D. Form 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APP.LICATION F�R WA�ER <br />Alt blanks must be filled in or crossed out <br />Everett� ........................ . <�-...... .�.�.................._......_.19 �-.y <br />TO THE SUPERINTENDENT OF TH WATER DEPART.'�IENT: <br />CITY OF EV�RETT: <br />I hereby apply tor the use oI water in sccordance with the rules and regu- <br />lations of the Water Department, for Purposes and fixtures stated below. <br />During the lime that any of the watcr mams may Ue taken uP by rcason <br />of any improvements authnrizeu Uy the City of Everett, m or of any strect or <br />alley ia wtiich thcy may have becn laid, the City will not be required to Lunush <br />water during thc progress of sucU improvements to any consumer wliose sup- <br />ply may thus be cut off, or br. liable for any dama,es tor its failure so to do. <br />Application No...���s.'..l...l�..C' <br />.............. <br />Block ................�--@..................... /L�o�t.......... a......................... Add...�:.'..!t.s�1���- yr <br />No .............�.�. ./.4✓. .. �.t.?:��-s��.^-.................. ..................... ...........5 trcet <br />The work to te executed U /1 �._....___....._ ..................................Plumber <br />y_........__�e:J "" = �['�"`J �%' ���� i ' '�'� I <br />r <br />Statc size of tap. /�C��..- � � �� <br />_..�i <br />...�...Tap to be inscried in the >daia °'�-[� <br />..._...._.....Natcr doset / oc ��' �tg• `;; � : <br />(OD -^� '� <br />.............Bath ' ;.. <br />�7/7%G`� .,, <br />4��%j .. � <br />................Urival - o.. F v,; .hUt�/ <br />................Pl�in faucet insidc L`� ��� ✓� <br />. 1(j.• C.f ��% <br />............_..Side �vallc washer . ` <br />.............._Hose bib outside �?e� �j� <br />................Hose bib for building purposes <br />................Hosc bib inside <br />................Bib for sta6lc coataining...............---..stall................... <br />................Number of pe:sons in family <br />................Number of rooms in building <br />Tlie premises are to be used as a .............................................................................. <br />The o�vner of the premises is ......................._.................................._........................... <br />TheaSent is ..................................................................................................................... <br />This application, althnu�h signed, s'.�all noG be binding upon the City, until <br />acceptcd by the Suges tendent of he 4�'ater D�p ent. <br />�,,"�' / � � .... /��........Applicnnt <br />SiSned...�c y.�^ .r....: �f-�ik.�. �!.:.... <br />AccePiad......................._..................1°....... By.._.........v............._..................................... <br />Superintendent. <br />