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/i �� � <br />W. D. Form 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATIOI� FOR WA'I'ER <br />Ail blanks must bc filted in ot crossed out <br />Evcrett,...._____........._��:.�f.-:� ../ .............................19:.`.:`:. <br />TO TF[E SGPERINTENDENT OF THE 1VATER DEPARTbTENT: <br />CITY OF EVERETT: <br />I hereby apply tor thc •�se ot �v, ter in areordance with the rules and regu- <br />lalions of the Waicr Department, for purpases and fixtures slated bclow. <br />During the time tlmt any of thc watcr mains may be tciken up Uy re.�son <br />of any improecmenis authorizcd by thc City of F.vcrett, in or of any strcet or <br />allcy in which they m�y havc bcen laid, the Cily will not be required to turnish <br />water during the progress of such impravements to any consumer «�hose sap- <br />ply may thus be cut o[f, or bc liable tor any dama�es far its failum ro to do. <br />Application No.��.��y...�f....... <br />Block.........,/_L.a ..............._... Lot__._....._.........__............. Add..�l.. _:_,. � _ . . . �... ..r.: . <br />No.._........_......_�.'.�.�'. �� �� — � ............Streel <br />.. .........................�. G:................................... <br />The tvork to be execuled by............__.... . .. _ . _. ... .. . . . . Plumber <br />Statc sizc of lap. <br />..�_��.....Tap to Ue inserted in thc main. <br />._._..........Nalcr doset <br />. ............... B a t h <br />; � <br />................Unnal ; � , . <br />.._............Plain faucet inside :'` . � ��� � <br />................Side walk washcr i'�,�, �.'L' � , <br />�,,: � i <br />._........._..Hose tib outsidc /� r` . <br />................Hose bib for building purposes � I � � � � <br />.:��. .,.. �'t' . <br />............._iiose bib insidc -., � , � '� <br />................Bib for stablc cantaining...................slall............. . .. <br />................Numhcr of persons in family <br />. ..............Numbcr of rooms in Uuilding <br />Thc pcemises are to bc used as a ............................__.__...._.... ...... .... <br />The owner of lhc premises is.._......._....._..._.__...__ ................._.__......_.. _..._ _... <br />T;ic agent is ..................................._._......__._._........._.............____................... <br />This application, although signed, shal] not bc bindin� upon thc City, until <br />;icceptr;i by the Superintendent o�f+ qic Waler Department. <br />Sicned.._..!�..�.L.,..... \,,.911�_�Sc..:k.w�._.�rr .............. .._._...._Applicant <br />:1�•crp;ciL__ _. . .._ . .. ... i!!. ... F3v ... .__. ....._.. <br />_ .. _. .. ._._._.__._... <br />Supi intondcnt. <br />