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W. D. Fbrm 4-1600—E.P.C..-6.26.24 <br />City of Everett --Water Department <br />APPLICATION FOR WATER <br />All blanks must be iilled in or crossed out <br />• Everett ........ ............... ...�ri.. ..... .7.'!�..........._.192. <br />TO THE SUPERINTENDENT OF THE WATER DL�T.ilI ENT: <br />CITY OF EVERETT: <br />I hereby apply for, the use of wader in accordance with the rules and regu- <br />lations of the Water Department, for purposes and fixtures stated below. <br />During the time that any of the water mains may be .aken up by reason <br />of any improvements authorized by the City of Everett, in or of any street or <br />alley in which they may have 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, or be liable for any damages for its failure so to do. <br />Application No... �....0/7.i ............... — %''f <br />l <br />Block............r7 ............... ........ Lot....t. ............................ Add ........ <br />f............... .......:......... <br />No ..... ....,/...'�.......1...../..`.l _.G..Fc.. ........Street <br />The work to be executed by ........... ....... ... ............................. Plumber <br />States//ize of tap. 1 o ao7 <br />.,_ ....Tap to be inserted in th main. <br />..._..._..Water closet <br />Both !- <br />........... Urinal <br />...........Plain lancet inside <br />.......`.....Side walk washer <br />...... ..... Hose bib outsidh <br />........ .....Hose bib for buiding purposes <br />.......`....Hose'bTb inside <br />..............Bib for stable containing ..... __........... stall...... ............. <br />.....` .......... Number of persons in family <br />... /.// <br />il //.......Number of rooms in building <br />The premises are to be used as a. ..................... <br />....... <br />.........._ <br />'be owner of the premises is..e............. ,gi . 2...........,.._.._... <br />went. is ..... ...................................... .................... _........................... ............. ........... <br />applibation, although signed, shall not be binding upon the City, until <br />v the Superintendennt/�',gf�Ithe( Water Deppar" rent. <br />Signed.f.........__!.�.'6' ..`' <" �✓�/�--�/l�l�.....A liwnt <br />.................................................. <br />p.....c4.19...... Byr�........ <br />/ en <br />Alb _ <br />