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�/'L-f/C'[�/" <br /> W.D.Form 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR �1A�'ER <br /> All blanks must be filled in or crossed out <br /> / i � D / <br /> Evcrelt........................................V..................................19�?� <br /> TO THE SUPERINTENDENT OF THE WATEf< DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance with the rules and r�gu- <br /> lations of the Water Department, for purposes and fixlures stated below. <br /> lluring fhe time that any of thc watcr mains may bc taken up by reason <br /> of any improvements authorized by thc Cily of Everett, in or of any street or <br /> alley in which they may have becn laid, the City will not be required to furnish <br /> water during lhe progress o: such improvemenls to any consumer whose sup- <br /> ply may thus be cut ott, or be liable for any damages for ils failure so to do. <br /> Application No.....,/�{.2.f.C�.�.._5........ <br /> Block.......................................Lot................/.................... Ad/d.................................. . .. <br /> No...................._..... 4 /..�� "L i< /......../NCiCu����.�et��. <br /> , ! <br /> ....�. 1..........:..........y............. <br /> ...................................................................................................................................................... <br /> The work to be execuled by.......................................................................Plumber <br /> State sizc of lap. /�A o "�'� <br /> f.. ... I'�,: ��.�f <br /> � Tap to be inserted in the main. � �" ' `5�' <br /> �.......Natcr doset !„1('��� �°�'�4����� <br /> ................Bath (^.it:' .i l:pri'-'t y j0/ <br /> . ................Ur:nal '.'� . , .. . <br /> ................Plain faucet inside � <br /> � ................Sidc walk washer —�/�cc�iz�f� /,[-C�-CC�L�'tiC <br /> . ..............Hose bib oulside �� <br /> ................Hose biU for building purposes � � j 7 ' S � �1j, <br /> ..Hose bib inside �"� <br /> .............. <br /> ................13ib for slablc containing....................stall.................... <br /> ...............Numbcr of persons in family <br /> ................Numbcr u[rooms in building fj,, <br /> The premises are to be used as a......... �� �-f(� <br /> 1-t....���...... _ ......_......_............_.. <br /> The owner of lhe premises is................._..............._................._.................._...._....... <br /> TSeaEcnt is..................................................................................................................... <br /> This application, although siFned, shall no be binding upon the City, unti] <br /> accepled Uy the Superintend t the at .epa rqent. <br /> r <br /> �ned._� ��.. .._<u`.��:..`�..........APPlicant <br /> ......�...«.... ....... <br /> Accepted..........._......_................_...1P....... BY...:/.._........_............................................. <br /> Superintcndent. <br /> � <br /> � <br />