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�i�% i <br /> W.D, Form 4 � <br /> CITY OF EVERETT-WRTER DEPARTMENT <br /> APPLICATION FOR ��ATER <br /> All blanks n:ust be filled in or crossed m�t <br /> Everett�..............._.........`T_2��....r.�._�.........._......._19�_:i <br /> TO TIIE SUPERINTENDENT OF THE WATER DEPARTDIENT: <br /> CITY OF EVERETT: <br /> I hereby apply for thc use of watcr in accordance with the rules and regu- <br /> l�tions of the �Valer Depazlment, for Furposes and fixtures stated Uelow, <br /> During thc time that any ot thc water mains may be taken up by rra=on <br /> of any improvements authorized by thc City of Everett, in or of any stract ar � <br /> alley in which they may have becn]aid, the City will not he required to fm�r i.�i� �f� <br /> «•�ter duriug the progress of such improvements .0 any consumer wl�ose c�,;;:- <br /> ply may t!ius be cu[ oft, or bc liable for any damages for its failure so tn � . a�'� <br /> �� /�.:�.�,7 ;�' <br /> PPlication No...... ... ... ........... <br /> Ulock_.....................--..... Lot..............................._...... Add...._.........................._ �?��. <br /> I DIo............��,.:J'.._....J...-.......�l......._.cCG....................................Slreet F�j.t�. <br /> i ✓�-f� .c�� r, <br /> __......................................................................._........................................................__ 5��' <br /> The tvork to Ue executad by....................................._..................._...... .._Pl�.c�.�.i� <br /> Stntc size of tap. �:�],� <br /> �� iA�; <br /> �--.%f.�...Tap to be inserted in the matn. h''i�+ <br /> ................Nater dosM � / � ;5S!�,� <br /> .._/......Bath � �� ( <br /> � .� `� '( <br /> Y� <br /> - ........IIrinal � ,•. � , <br /> ,, t��y <br /> .. ........Plain faucet inridc � - .. ��`� i� y _i� <br /> ................Side �valk �ra�her �S. ��" d� :� <br /> ................Hase bib ou'slde .�`'��� iY �'� <br /> �............._Hose 6ib for buildir.g pm�poses � f y ieti2 '� .y� <br /> C u, �''`'� �+ <br /> ...... ..Hose bib ia.idc ��.� .. � <br /> �.. ... ...Bib for etaLde containin•... st�ll "\ <br /> � 6 . .... . :.._......-- �.��. <br /> - -.........._NumUer d persons in fam�ly <br /> ...-.L ...Numbcr of rooms in building '�-�:',� <br /> Thc premises are to be used as a .... . . ___ � <br /> ....._ ......_. __... <br /> 'Phe owner of tl�e premises is_... � <br /> __..... ...... ._.....___.._.__.. <br /> 'Chc agent is........._........................................_................. �� <br /> ... ......_........_._......._...._..._.. <br /> 'i'iiis applic�tion, although signed, shall not be binding upon the City, unLl <br /> acecpted by tha Superinte dent of fhe ater Department. ! <br /> �' � �'" <br /> SiSned...._-Z.:._� `-�c�t--•.c <�'._�............A; Plicant �. a <br /> .........._._. ._......................... � <br /> AccePfed.............__.........................1�....._ B �"w� <br /> y........................_...._............................ .... .; <br /> SuPerintendmL � �.� <br /> `r� <br /> 'i <br /> Y ' <br /> :. ,.t <br /> �i,:� <br /> 4,t�f <br /> ,"�'k1 <br /> i.«-�. <br />�� i:_' J <br /> . .. _....s� .r,. . _ ... . .. ....,_ . -' . :.:'.._ . ..._ .. _ . � <br /> w_ �.. - . -. ., ., <br />. .,... � ..� .,« . ,:. . .. ....«....„w. .... .. . . . . .. _ ..an.� <br /> ._ w.��_ .,.t�•..— .�_._._.r-..w. .,..M,:.__. . - ... . � _. - ` — ��____' __'_.__�._._.� �.._.._�_ .... . <br />