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%%�y <br /> W.D. Fo�m 4 <br /> CITY OF EVERCTT—WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> Evcrclt,._._._...._........_:.,Y,:.�._..%......:�_..............._.__....1�3�..`.:� <br /> TO THE SUPERINTENDENT OF TFiE WATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hereby aPP�Y tor the use of water in accordancc wilh the rules and mg�- <br /> ]ations of thc lVater Depc cment, for purposes and fi�lures slated Uclow. <br /> During the time that any of thc watcr mains may be taken up Uy r��ason <br /> of any improvements authorized by thc Cily of Evcrelt, in or ot any strect or <br /> alley in which lhcy may havc becn laid, the City will not Uc required lo furnish <br /> a•ater during lhe progress of such improvements to any consumer wliose sup- <br /> pIy may lhus be cut oft, or be 1!abin for any damages for ils tailure so to do. <br /> Application No....��_/...::��'......... . <br /> B1ock.......G.�.Y. ....Lol_.f.l.,...�...t;..-.'..�j...... Add...Ci�.'.<,��p.,r--�.c..�c...... <br /> ...... ............ C <br /> No............_..../�..� � F . �t-ho.� .......Strect <br /> ............................................................................... <br /> The work to be execuled by.................._......................................_...........Plumber <br /> Statc sjze ot tap. ,t-.. ;�..x��"'� <br /> � .....;.�y.Tap to be inserted in the maia u� �„ ,p.�--�-�'�`-O"` <br /> � �'. <br /> . . ._..Walcr doset '7 �� /i• :,.����'- .�- <br /> � � � �.r'.......Batlt ��,o/L <br /> I / ',... � <br /> . � �.Bn>� <br /> ................Ur�n al <br /> ��� .._.__.......Plnin faucet insidc '/� <br /> ................Side walk tvashcr �- � �/ + <br /> ..._........._Hose bib outsidc _,�"'��'�� Xd � <br /> � ' � -t <br /> ..........._...Hose bib for building purposes � � <br /> HaS� �,b��,d� FFc, �- sa ;a , <br /> ...Bib tor stable contninins... ..- --.. stall..._.....C�ty.np Everett <br /> .. ..`.. �.....Numbcr o; persons in family DEPT• �� <br /> -� �f.....Numbcr ot rooms in Uuilding WAT�� <br /> Thc Premises are to bc used as a.._............__.....__............_........_........._................ <br /> Thc owncr of the premises is......__......._.....................................................__........_.. <br /> TheaEcnt is.................................._.._.................._......._............_....._........_._...__........ <br /> This apP�icalion, although signed, sh�ll not be Uinding upon the City, until ._ „ ., • . . <br /> accepted by ihe Superintey�et�t of lhe R',y�cr D artment. � � � � . '. •':v�- . ..'�Ei�l• � <br /> Signed.�.C��..���a.'G.-\.....���!'S-. .. -�.. Applicant <br /> 7 <br /> Accepted...........................................1P....... By.._...... . ��.. <br /> .. ...__.._...._.._....._...................__.... <br /> Superintendenl. <br />