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. .�-C, ..�.G� <br />W. D. Fo�m 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must he filled in or cirossed oui <br />Everett,......_ ........................._�.. �....�..,......_.__......19_.�� <br />TO THE SUPERiNTENDENT OF THE WATER DEPARTMENT: � <br />CITY OF EVERETT: <br />I hereby apply for the use of w2ter in accordance with the rules and regu- <br />lations of the Nater Department, for purposes and fixtures staled below. <br />During lhe time that any a[ thc water mains may be taken up Ly reason <br />ot any impmvements authorized Uy thc City of Everelt, in or of any strect or <br />nllcy in which they may have Ueen laid, the City will not bc required .e furnish <br />waler during the progress of such improvements to any consumer whose sup- <br />ply may thus be cut off, or be liablc for any damages for its failure so to do. <br />Application No...�_�..��. � <br />... . .............. <br />Block...........'7_�. � Lot .l'.'�.__.� .. A d ...... .....__._... <br />� �i - . � % <br />i�D.'' J. ..� ��lL-,t�lb � :-GG�(,...Strecl <br />. . .. ... . ............ ....... . ..... ....... �.... .... . .............. <br />The work lo Uc executed Uy...._........._____.... ..._..... ...__.._.... ... Plumbcr <br />State sizc o[ tap. <br />_...._........T;ip to be inscrled in thc main <br />_ .............Watcr doset <br />... ............. A � t h <br />....._...._...Urinal � B �d r � <br />...._..........Plain tauccl inside �rrr'''��� i �, <br />._......._....Sidc walk washer � "�ti:-c i: rJ <br />r . <br />._ .............Hose bib oulsidc E� s� S"uJ f/ <br />. ..............Hose UiU for building purposes � <br />Citp c+t [VefetC <br />.............._Hosc bib inside <br />..........._.Bib for slablc containin w�� � ��Pr� �' <br />� 5............_.....stall ............._..... <br />.__...._.....Nwnbcr of persons in family � <br />>; �. u . /1_l� �� � <br />. .._......_NumUcr of rooms in building � , <br />. L!o ,ct t �t ,e : c �� <br />1'he �rnm�ses arc to Uc uced �s a...___ �1��.,._.. ... _.... <br />Thc owner ot the premises �s ......_. _.. <br />`'- /���D <br />..><< Gc�l"�i'-, Cl��._.._. <br />Thc agent is..... .... . .. C. . ........... <br />u , vf ,�c y.._, cz-rti/ <br />This apphcation, althou ��igned, shall not � Uie��pon thtC�ty, until <br />accepted by ttliq_� Supecryip tendenl('�of the R'aler Departn,�nt, <br />.� 5 ned. `l, b�.�'.._ \ Ol::�.:�:!�. �� ..`_"� .�r. ..._.. _......._...APPlicant <br />!\�crp;ed _. . . _ . ._..._ .l;!.._ . Uy .__._ . ....__ ...... .........._.... <br />Superintcndent. <br />