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W. D. Form 4 <br />CITY OF EVERETT—WATER DEF.ARTP„ENT <br />APPLICATION FOR �1ATER <br />All blanks must be filled in or crossed out <br />Everest� ..................._��:._ �,.-..........._......................._191-..!... <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with lhe rules and ;egu- <br />lations ot the Nater Department, tor purposes and fixtures stated Uclow. <br />During lhe timc that any of thc watcr mains may Uc taken up by reason <br />ot any improvements authorized by thc City of Everett, in or of any strect or <br />alley in which lhey may have bcen laid, lhc City wil] not Ue required to furnish <br />water during the progress of such improvements to any consumer whose sup- <br />ply may thus be cut oft, ar be liable tor any damages for its failure so to do. <br />APPlicalion No...j �'.,f.5.�fi .............. <br />Hlock........................................ Lot........................................ Add........................... ............... <br />No ........... ... ' ✓ :• <br />J. �.':.'....7 ..................�,�?...�.a�f,LxtT:...�i:.K.,.,...........:...........5trccl <br />.................................................................................... <br />The work to Ue e�ecut_d by ...................... <br />Statcsizc of tap. <br />...��`�._'Pap lu Ue inscrled in the main. <br />........ ..�Valer doset <br />_�. ��.Bath <br />................Uri nal <br />..........._.._.._....__.Plumber <br />�l u'S � L�11'`l �l'r/'� <br />�/1 J <br />f�i'i �'rs�,Jr ';, <br />................Plain faucet insidc r J� <br />.............. <br />..Sidc walk: washcr ('.p„�� i`':c,"_tt ��,�� �d. <br />................Hose biU outside S., ��'i LR DLI' 1. Li ,J �� <br />'I' <br />...._........_Hosc biU tor building purposes <br />................Hose Uit� inside <br />................Bib for stablc conlaining..._..._....._..st�ll...___.......... <br />......_.......-Numbcr of persons in family <br />._.;:_.......NumUcr of rooms in Uuilding <br />1'h�_ premises erc lu bc used as a....._...__........_....._..._. .....__ ._..._._. .._ ... _. <br />Thc owncr of'.he premises is ............ .____ .___.._ ..._._._.. <br />Thcagent is.........._............__..........__ ............................__...._....._............................_. <br />This applica'.ion, although signed, shall not bc binding upon thc City, until <br />accepted by th� SuPerintendent of thc Watcr Departmen�, <br />./'> ' .�s� -' , <br />S�.Sm .1�..../L...C..G.r�:...c:,�:�7?... f.....-C_'-/'u'..._...Applicanl <br />A�crpted ._.. . . _ ._.__..IP..._. 13}' ._._ ........ ........_. ._..._......__.... <br />Superintrndcnt. <br />