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/�/=7 <br /> W.D. Fo�m 4 �' <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed oul <br /> Everett�................ ........._.....�i.6..;.�...�'...s ..._.........19.1_� <br /> TO THE SUPER[NTENDENCIT�Y OF EVERE TDEPARTMENT: <br /> I hereUy apply tor lhe use of wnter in accordance wilh the rules and regu- <br /> � lalions of the Water Department, for purposcs and fixlures stated belou•. <br /> During the time lhat any of lhe watcr mains may be taken up by teason <br /> of an}' improvements aulhorized by the City o[ Everett, in or of any strcet or <br /> allcy in wh�ch thcy may have been]aid,the City will nnt be required to furnish <br /> ±'� water during thc progress of such improvements to �ny consumer whose eup- <br /> i ' « ' '���x , - � � �. '� ply may lhus be cut of[, or be IiaUlc [or any damnges for ils tailure so to do. <br /> ' <br /> <; . �' ' ' '�p ` <br /> ., �c �� `R� �� - r �� I APPlication No......✓�.':..... ..i_1..... � <br /> � � ' ' ... . ` , , c � �/�! -a.�,.^Gr:=:,./ L-� <br /> . � � ' �� -� Block..........r�.................... Lot........�y ....... Add..: <:..---..... . ...... <br /> � ,., , -�_. . <br /> - . � � �3.:i ��'!—+�_.Lti.�.............................................Steeet <br /> No.........�.,..�.............................................. <br /> ........................................................................................................................._........................... <br /> Tl�e work to bc executed by.. .-.... .._.....Plumbcr <br /> .................._...._..._...................... <br /> Sla�te/sizc o[ tap. � <br /> ...;J...'�..Tap to be inscrled in lhe main. <br /> ................�Vatcr closet � _ <br />�, q �, ,, �: <br /> ..../...........satn . , <br /> •� <br /> ................Urinal /r�r' . 'i.�� y � 7 -?, <br /> ................Plain taucet insidc �1S � i� i �', , <br /> �� • � <br /> .....Side walk washcr Cil� :-r: <br /> ........... . <br /> r, . ,� <br /> i ..............Iiose bib outsidc �vqTf,?Q �v�;ett �-' - °,• <br />, .� <br /> .............._Hosc Uib tor building p�rposes ep�; ,t�, -' � <br /> �F <br />, ................Hose bib inside <br /> I ................IIiU tor stable containing...................-sWll................... <br /> ...............Number of persons in family <br />�� .._.-.�1...._Numbcr ot rooms in building <br /> Thc Premises are to bc used as a.........................._...._.............._..........__........_...... <br />� Tlic owncr of thc Premises is......._.__....................__.................._.........................__. <br /> The agent is..............._.._. ........_......._............._..._.........._....._.......... <br /> _._......___...._.. <br /> This application, a);hougl� signed, shall nnt be bindin�; upon lhe City, unlil <br /> accepted by the Superi� t ndent o[ the �i'ater Department. <br /> f' -}� � '/ /�) <br /> Si�necl.'.:.-r.tr'��,.'Z...........):.`.�_1..........�C��-.7�:�'..................Applicanf <br /> � .. <br /> Accepted.__._.. _..... ...... .._._.__._..1^....... By... .._..._............... .................................... <br /> Superintendent. <br /> � <br /> l � <br />[ J <br />