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W.U. Form 4 <br /> ClTY OF EVERETT-W'ATER DEPARTMENT <br /> APPLICA'�'ION FOR WATER <br /> AIl blanks must be filled in or crussed out <br /> — � // <br /> Ever tt, .._�.:� . _'....i :.........�._. _. ........._...19_........ <br /> TO THE SUPERINTENDFNT OF THE WA�I'ER DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hereby apply for thc use ot water in accordance with thc rules and regu- <br /> lations ot the Water Department, for purposes and Cixlures slated bclow. <br /> During ihc timc thal any of thc waler mains may Ue laken up Uy reason <br /> of any improvements auihorized by the City ot EverMt, in o: ot any strect or <br /> alley in wLich thcy may havc Ucen laid, the City witl not be required to furnish <br /> water durinC il�c progress of such improvemer+s to any consumer wl.ose sup- <br /> ply may thus be cul off, or bc liable for any damages for its fai7ure so lo do. <br /> , ��. <br /> Applicaliou No..�S-.�:�.._`.e; <br /> ..................... <br /> ock. ... ..J�ot ��.° P?�.� .�.-r/ Add.,�.. . _._ .... ... ___.. <br /> � <�, <br /> No . I� � l . . . . � �' '� .Slrect <br /> �,. : ._ .._�: ... :_ _✓:,. _ : __...._.....�.-j...r._��._.)...........{. ........ ..... <br /> _. . <br /> Thc wm�k to be execuled by..............__..._.._. _. ..._.__._.................._._Plumber <br /> `�S �te size ot tap. .- - <br /> �.........Tap to be inscrted in lhe main. i�'' ' "- n " ' �� � ' <br /> ................Watcr doset � _� . <br /> �: -__ .- . �., -. / . <br /> ................Bath � . � . ,. <br /> ................Urin�] � � . <br /> ...............Plain taucet incidc ��- .�"���.�. <br /> f' <br /> . .....Side walk washcr <br /> .......... <br /> �_ - <br /> .............._Hosc bib outside • � <br /> � n_�i' <br /> ......._.......Hose bib for building purposes � <br /> ................Hose bib inside <br /> ...._..........I3ib for staUle containin�..............__..�la❑ _. . <br /> __...........NumUcr of persons in familp <br /> ..._. ...._..Number ot rooms in triilding <br /> 'Phc pramises are lo be usal as a...... ____. _ .. . , ._ . _. . . _. . <br /> The owner of the premis^s ,s......_ . .�._._... .:�__'. . , ..._ .. . ... . <br /> TSeagent is. .. .......... .. ......... ._ . ............... . __........... , . __._. <br /> This ap�licalion, althnu�h signed, �hall nnt be bindinq apon lhe City, un�.il <br /> aceepted by the Superintendent of lhc Waler Departmenl. <br /> Si�ned_....._.__...........__..._............................._...__..._................Applicant <br /> A�rrp�rd ....._.. . . .._. ._. _. ._. ?�....... 13y... ..... ....__ _..... <br /> .. _. . . __.___... <br /> Supennt��ndrnt. <br />