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i <br />w. D. Form 4-1600--E.P.Co.-6 26-Y/ <br />City of Everett --Water Department <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett,.........../." /1. S/_ v," ......................19"...... <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />lations of the Water Department, for purposes and fixturea stated below. <br />During the time that any of the water mains may be taken up by reason <br />of any improvements nuthorized by the City of Everett, in or of any street or <br />alley in which they may ksve been laid, the City will not be required to furnish <br />water during the progress of such improvements to any consumer whose supply <br />may thus be cut off, o(rr��be IJi�ble for any damages for its failure so to do. <br />Application Na..... LF...li!.y............ <br />Block..............:.......le......... Lot ........... — .r....................... Add._.. ...... ............... _........ ...... <br />No./.,_O.y......48.Lc-.C'V"'«...............Street <br />........ ............ ............ <br />....................... ................................ ....... .................................... <br />The wcrk <br />to be executed by..... (�/ <br />.... ..:5-.... ._ .......Plumber <br />Slate size <br />of tap. <br />.... <br />Tap to be inserted in the main. <br />.....[.........Water <br />closet-�. <br />............Both <br />...,,.......Urinal <br />...Z.........Plain <br />faucet inside <br />...........Side <br />walk washer <br />..............Hose <br />bib outside <br />Cl <br />' <br />Hose bib for building purposes <br />�--�- <br />..........Hose <br />bib inside <br />...../'......... <br />Bib for stable containing....................stall................... <br />/ - <br />.....,Y....... <br />Number of persons in family <br />..........Number <br />of rooms in building <br />The premises <br />are to be used as a...........-:G:G'"""' <br />......... ................................ <br />The owner <br />of the premises is.G%%.J........... <br />....... _=.,1,,...... .. <br />Thengent is...................................................................................................................... <br />—'fls application, although signed, shall not be binding upon the City, until <br />tcd by the Superintendent of the Water Department. <br />(, <br />