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/�/� � - <br />W. D. Form 4 <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATIO�N FOR WATER <br />All blanks musl 6e filled in or crossed out <br />�;�-f „Y ' <br />Ev�r��t,.__.... ..._.........._. ........ ..............._... ..��J� -.Y.. <br />TO TFiE SUPERINTENDENT OF TFiE NATER DEPART4IENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />lations of the \Vater Departmenl, for purposes and ti::tures stated belo�e. <br />During lhe time that any ot thc watcr mains may Ue taken up by rcas-on <br />o[ any improvements �ulhorized by the City of Evcrett, in or of any strcet or <br />allcy in which they may havc bcen laid, lhe City w;ll no: be required lo [urs�sh <br />waler during lhe progress of such improvements to am consumer whose sup- <br />ply may thus be cut of(, or bc liable for any damages for its f:;ilure so to do. <br />APPlication No...�.�..�...�.l.....�......... <br />Block ....................................... Lot..........��......._....._. Add.....I�C,�snoLy..N<ll:�... <br />r/ � 4/ <br />No ................._...../..�.G�..._/�����>4.�..._�-V ...........S/rcet <br />The work to be executed bp ................_.... <br />Sta(� izc of tap. <br />._'�iY.Tap to be inscrled in lhc main. <br />... ....Natcr doset <br />.. �.�� ....Bath <br />_._........... Jrinal <br />__.........._Plain taucet inside <br />_..... .......Sidc wnik wasl�er <br />_.... ._..._2iose bib o�.itside <br />...._......_...Hose bib for building purposes <br />.__...........Hose bib insidc <br />.............. _................... _....P] umbcr <br />/ ',/ <br />,���'Q�q � <br />� ^ L ", <br />l �7r`� , � � � <br />y ) <br />r_- . ',! � �Y .� <br />�n <br />� • i� id <br />C.:; cr �;�cre:: � ' <br />'„/.TGR DLF`. <br />�' <br />......_.......Bib for stablc containing ...................stall................._. <br />....... _.;....Numbcr of persons in family <br />......�� ..Nmnbcr of rooms in building <br />The nr.;nises arc to bc used as a...._..._ ............._.._._.._......_... .._ .._... __... <br />The awner of the Premises is ................._..._.....__._._........_..__. _._._..... .._. _... <br />TheaSent is ....................................__....__.................................._.._.............__............. <br />This apP��calion, although signed, shall not be binding upon the Cily, until <br />accepted by the Superintendent of the Plater Departmenl. <br />Si�ned._............_...._ .................................._..............._..._.... ........Applicant <br />A^crpted.__ .. ...._._. __l^.__.. By __._ .. .......... . .. .... ..... _._.. <br />Superintendenl. <br />