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W. D. form C <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett..,........................1/ , 7— �i <br />......... <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu. <br />lations 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 <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, the City will not be required to furnish <br />water during the progress of such Improvements to any consumer whose sup- <br />ply may thus be cut off, or be liable for any damages for its failure so to do. <br />Application No ... <br />Block..4 ................................ <br />The work to be executed by ................................. <br />State size of tap.i <br />• <br />.......Plumber <br />�. <br />./...........Tap to be inserted in the main. <br />................ Water closet <br />oa�y�j <br />l <br />........ ....... Bath <br />/C�n� <br />.............. Urinal <br />CA, .. <br />................ Plain faucet inside <br />• ...............Side walk washer <br />Hose bib ts' <br />i ou 1de r�7) <br />................Hose bib for building purposes/�� Cvc_'Z% <br />.............. Hose bib inside ✓��,rQ� <br />................Bib for stable containing ...................stall.................... <br />•............... Number of persons In family <br />............... .Number of rooms in building <br />The premises are to be used as a ............... <br />.................... <br />The owner of the premises is......................���•.f..�........ <br />...� .. <br />The agent is ........................................................ ct-scL 1!%.r' -......... <br />......................................... <br />This application, although signed, shall not be binding upon the City, <br />�� until <br />accepted by the Superi�eoft Department�Signed....,.. t <br />Accepted ...................................... ......1@....... 13 .... .. <br />Y................... ....._.......................... <br />Superintendent. <br />