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W. D. Form 4 1500 0-1-17 C. P. <br />C1TV OF EVERETT==Water Department <br />Application for V/dater <br />All blanks must be filled in or� sey/.11/ ut <br />Everett.._____ _______191�___ <br />TO 7 1::•, 3OPFRINTENDENT OF r WATER DEPARTMENT, <br />ITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regula- <br />tions of The Water Department for purposes and fixtures stated below. <br />During the time that any of the water mains may be taken up by reason of <br />any improvements authorized by the City of Everett, in or of any street or alley in <br />which they may have been laid, the City will not be required to furnish water during <br />the progress of such improvements to any consumer whose supply may thus be cut <br />off, or be Ifrtble for any damag� for its failure so to do. <br />Applicatioppn No._1l J3 .. ______ /If,- Q <br />Block_-/- Lot___ _— —_�-._____Add_--_--.__—_._----- <br />--------------------- ________________ --------- <br />The work to be executed by________ "— .u ___ Plumber <br />State size of tap. <br />___/ _Tap to be inserted in the mam. 6,0 <br />(_--- Water el Beet <br />---.Bath / <br />.Urinal <br />---------- Plain faucet inside <br />________Side walk washer <br />---------- Hose bib outside _. <br />__________Hose bib for building purposes AP P ". U Ig?1 <br />._________Hose bib inside For- <br />---------- Bib for stable containing ------------ s <br />____ _Number of persons in family <br />_____Number of rooms in building <br />The premises are to be used as a ------------------------------------- _____. <br />i., The owner of the premises is__________________ <br />..,t <br />Theagent is ---'---_.'-------'-"--_.-'--'-'-'-"_"_---'_.______"---- <br />This application, although signed, shall not be binding upon the City, until ac. <br />cepted by The Superintendent of the Water Dep ent <br />Signed _ ___ ___ __.__._ -------- Applicant 1 <br />Accepted-- __ -----19L y -- <br />--G �% '��✓ SuDertntandem <br />