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:� ��' J `J� J <br />W. D. Form 4 <br />CITY OF EVEftETT-WATER DEPARTMENT <br />AFl�LICE`�:TION FOR �ATER <br />All blanks must be filled in or crossed aul <br />�veictt,.........._ .... ........._._......�....:....5!�._.�l.i...........19 �: ,__. <br />TO THE SLIPERINTENDENT OF THE WA'CER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for Uie use of water in accordance witn ihe rules and regu- <br />lations of tne Water Dep2rtment, for purposes :m:i fi�lures stated below. <br />During lhe time that any oi the water mains may be taken up by rcason <br />o[ any impivvements authorized by the City of Everelt, in or of any strect or <br />alley in which lhcy may havc becn laid, lhe C�ty mill not be requimd to furnis'i <br />water during !he P�oBrc;> of suc6 improvements to any consumer ahise sup- <br />ply may thus be cut off, or bc liable tor any damages tor ats failure so tu ��. <br />Application No...�.�._..`�...%...�..........! .�1�_ e i...< . . . <br />. � - � <br />131ock ......................._............... Lot....... ..:.'........................ Add...Ll!C�.c.._�.c_.-�____. <br />'� , l. . /� n <br />x� .................../....3..:>G-...._/.c�.c..5,.l�_C..:......q.:..!L� x............strc�i <br />Thc �vork Lo be executed by .. ................................... <br />Statc sizc ot tap. <br />.�,..��.....Tap to be inserled in the main. <br />.�_..........Naler doset <br />._ ._ _ _ ... rlumUcr <br />P'j: j r, r� <br />r, , �rs.`,,.,L. <br />................Bath 9. �"�+ �� � S. � � <br />................Urinal wr k <br />p .�p <br />................Plain faucet insidc %P�U V� ��.' � <br />................Side walk washcr `�.r )�°' 3 6 y y <br />................Hose bib oulsidc City of Everett <br />................Hosc Uib for building j��urposes ��4TGR DEPT. A <br />................liose Uib inside <br />................Bib for slaUlc oontaining....................stall.................... <br />...._..........Numbcr of persons in family —� 1 �� �� <br />..__....._...NumUcr of rooms in Uuilding /� � �� �,� /��� , <br />Thc Premises arc to be used as a._._._ .......................�......... -_...,........... ........... _.. <br />............._� L"�-c <br />The o�vncr of lhc premises is ....................... ..............Z.................._......_ _. <br />Thcagent is .............___.....__.__....._......_....................................._.............._............. <br />This application, although dgned, chall not be binding upon the City, untii <br />acceUted by Qie Superinten�ent ot thc �Patcr Deparlment. <br />� . <br />� / <br />-- <br />SiSned f...:...�%/2.±�.� )!f.::G!::� .�1t".... ,.,(%..1.L...L3.�./.1......Applicant <br />T <br />A^cepted ____. ...__._......._.7^....... By . ........... ._ ....... ..........__... <br />Supci mtendcnt. <br />