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�y. D. Fo�m 4 <br />C� � <br />! ' ' . <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett,......_.__...... . . J...' /�...._._......___..._I'J_.��_�� <br />TO THE SUPF,RINTENDENT OF THE �VATER DEPARTi\1EN'i: <br />CITY OF EVERETl': <br />1 hereby appl}� tor the use of water in accordance «•ith the rules nnd regu- <br />lations nf the R'ater Department, tm• purposes and fixtures sWted below. <br />During thc timc that any at thc watc� mains may �e t,�.ken up by reason <br />ot any impro���ments authorized Uy the City ot EvcrMt, in er of any street or <br />allcy in «•hich thcy may 7i��,� bcen laid, the City �,vill not bc required to furnish <br />�vater during the pngress of such improvemenis to any consnmer whose sup- <br />PIy may thus be cu[ oft, or /be ]iable for any damages tor its failure so to do. <br />�`' � � � <br />i <br />APPlication No. . .. ...... . C...GC � <br />Blnc�...... . ' . <br />.. .. Lot�' / /— <br />..�... .........Adsi�c_:.�..n _.C..r..�:-<-�_ <br />No...................................�..J... . �../__� <br />/ �.... . ...._LS.-C.:. -�... ..Stre <br />1 .................. <br />............................. . <br />. .. . ... � <br />i <br />. _ .... .. ... . ....................... ....Y..,._.:..:..::c� �.-,�_,� � <br />. .... ............... <br />The work ta he executed by .........................._..._................... . <br />..........._._Plumbcr <br />State size ot tap. <br />��-��_�.........Tap to be inscrted in the tnain. <br />_..../ , <br />._..�Valcrcloset /.0 �`�i �c4t_C=�� <br />J <br />l.. �,.,,:..Bath .. <br />._ � i V'.':.:3�� <br />................Urinal `. <br />.....-.-.....Pl�in faucct iu;i,lc . <br />..__......_..Side walk ���asher <br />�-��.........Hose bib ou[sidc . <br />� -��.........Hosc hib tor 6uilding purposes � � <br />������-........IIose bib inside � <br />................Bib ior stnble conlaining...._._....... '� <br />__stall..__..........._ . <br />-�����_-.......Numbci� ot persons in tamily � c.' -- ° <br />�....•� l Number o: reams :n building � <br />....... � � „ , <br />The premises are to be used as a.._._._...._. _. �� <br />._._. . ...__..._ _ _........ .. <br />Thc owncr of ihe premises i;.......__.. .... ..... <br />....__....__.. <br />_..... ..._....... . _ _.. . <br />. .._...__._. <br />..c agenl is_....__.._._......_ . . <br />......_..__..._.._..... <br />. _ ........... ..... .. <br />1'his application, al hough signed, shall nat be' . ................... .... <br />acceplcd by the SuPcqinlendenl o[ the Nater T-� - F"�on lhe Cit}•, un;il <br />_. f- .� .. . -� � .. <br />SiCned.__. �..�r .�...��C1.�1C_..__... ... <br />_..... _......_ ................_.___r�pplicant <br />Acccpteci.__ . ..... ...._.._19._.._ R�•. <br />.... __.. _ . ..._. ..___....__........ <br />_......__ .._ ............. <br />Superinlcrdcnt. <br />