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W. D. Form 4 <br />�ITY OF EVERETT—�`VATER DEFARTMENT <br />APPLICATION FOR WATER <br />All blanks musl be filled in or croesed out <br />�% � <br />"= t%....�.f ......................._191.� <br />Evcrett� ........................'.......'.- <br />TO THE SUPERINTENDENCIOYF `'F EVERETTDEPARTMENT: <br />I hereby aPP�y for the use of vater iti accordnnce with the rules and reSu- <br />lations o[ the \Vater Departmeni `ir purposes and fixtures slated Uclow. <br />During the timc that any ot tt�e water mains may bc taken up bY rcason <br />ot any improvements authorizeel by the City of Everett, in or of any street or <br />allcy in wh�ch ihey tnnY nave becn ]aid, /he Cily will not Uc required to furnish <br />water during the progress o[ such improvements to any consumer whose s�p- <br />ply may thus bc cut off, or bc ]iable for any damages for ils failure so to do. <br />Application No.�..�'./..�.<!..7 ................. <br />Block ........................................ Lot._......_..._.'. <br />_....._..._..... naa... ._ .............._........__ <br />!".�// '/ � ........__.....Strcet <br />... /�<._ �C.f:e.:.w�.�..........�?"�Z ............... <br />Na........�� ... <br />.............. �. .... <br />._. ._.__._ .._....___._.__Plumbc: <br />The work to be executed by ....................._.._. . -- <br />Statc size of tap. <br />.,-��..Tap to be inserted in the main. � <br />._. .....Nater doset J <br />,� <br />�. .....Bath n � �'y/: �.J , <br />...�............Urinal OFe, 2� ,�E/" .y -� C, <br />__............Plain faucet insidc ` (J�f� tJ4�'r /d � �U <br />J <br />................Side walk waslmr �'V�r �f (';.., % 7 ,,, <br />..........._...tIosc bib outsidc f� D' •: �-t' � . � . <br />.pT.�.� c.� <br />r, -- <br />................Iiosc bi6 for building purposes ::� <br />.............._Flose biU inside <br />....IIib for staUlc containing ....................stall_._._..._. ... . <br />,�.......�.....Number o[ persons in tamilp <br />....�......Nmnbcr oi rooms in buildinF <br />The Premises are lo bc used as a ...................___ ._. _.. _..___ ... .._. <br />..... . . . .... <br />The owner of lhe Premiscs is ..................._....._.. __. ____._ __._.. __....__ .__._.... <br />T:ie aSent is.... ._...._...... .......................__......... <br />.._ ........... ......_....._.......__...... <br />This application, allho�Fh signed, shall not Uc binding upon lh^_ City, until <br />accepted by the Superintendenl af the R'ater Deparlment. <br />• ( ' ,.� � ........Applicanl <br />SiSned...:(��`..:...._ �4.'.._._....._....._..........._.._ ..................... <br />.......19.._... Sy......._........_......._. _ ...................._.._._._.. <br />AccePted... _ _....... _ _. _...,-_..... _. Superintenden t. <br />