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� � <br />W. D. Fo�m 4 , �� � A. <br />CITY OF EVERETT-WATER DEPARTMENT <br />AF�LICATIOI� F'OR WATER <br />All blanks must be filled in or crossed out <br />Everett ......................._.__ Cs't�. /.i.::........................19 �.� <br />TO TH� SUPERINTENDENT OF THE W9TER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply tor the use of �•�ater in accordance with the rules and regu- <br />lations of the Water Department, for purposes and fixtures stated below. <br />During thc time that any of the watcr mains may be takcn up by reason <br />of any improvements authorized by the City of Everett, in or of any street or <br />alley in which they may have been laid, thc City will not be required to turnish <br />water luring the progress of such improvements to any consumer whose sup- <br />ply may thus be cut off, or bc ]iablc for any damages for its failure so to do. <br />Application Nqlf %'% :............. <br />Lot..._....... __.. .. <br />Q <br />The work to be executed by ...................... <br />Statc size ot tap. <br />_1..�..,.Tan to be inserted in the main. <br />..._.._........Walcr doset <br />................ B a t h <br />................Urinal <br />......._.......Plain faucet inside <br />.............._Side walk washer <br />................Hose bib oulside <br />................Hosc bib for building purposes <br />�J�_...—n�a--a —............... ........... ___ ....... <br />.. .GCr, r�s:c±�. :.�. _.. _. S t r e c t <br />:l ...................................................... <br />....... _ ............._............._ _....Blumber <br />\ <br />\ � �' <br />r•� � <br />��J � � <br />�' `� t� <br />, `� � <br />� <br />C�� <br />� <br />................Hosc hib inside <br />._.... .......i3ib tor stable containing ...................stall................._ j� . <br />. ..Numbcr of persons in fami]y � <br />............_..Numbcr of rooras in building <br />7he premises are to Le used as a ....................................__.......__......._ __..........._. <br />Thc owner of the premises is._...__.__.....__._........_......._............_ ...................._._. <br />Thca�ent is....._ ...................__..........._......._..........._..........................._............._._.._. <br />This application, althouqh signed, shal] not be binding upon the City, until <br />acccuted by the Superintendent of the Water Departmr.nt. <br />� � ./ <br />SiSned..:�l.../Yc c�Lls�.,r.. �.� �.1.:I.zy..a:.. �=�:�1.^,��a.�$AY:L...Applicant <br /><lecep:ed...._._._._.._ ..............._._....19.._... BS'_....._......._..__.___.............__.._................ <br />Superintendent, <br />