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W. 4 ii.:m 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blank; must be filled in or crossed out <br />Everett ..................... <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />lations of the Water Department, for purposes and fixtures states' below. <br />During the time that any of the water mains may be taken 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 sup- <br />ply may thus be cut off, or be liable for any damages for its failure so to do. <br />Application No.....�.Z1./....e':.$4..... <br />Block ...... ................................. Lot,/../._,a<..../..%.......... AddL ................... ...._....... <br />No ...................................... d -c a��-U�-•i. <br />iZ.. ;?.._f.......... t..-._ _............ iF.....�Sireei <br />The work to be executed by......................................................................Plumber <br />state size of tap. <br />4........Tap to be inserted in the main. <br />................Water closet <br />.....{........Bath <br />................Urinal <br />................Plain faucet inside <br />................Side walk washer <br />................Hose bib outside <br />................Hose bib for building purposes <br />'71 <br />................Hose bib inside - <br />prZ <br />................ Bib for stable containing .................... stall .................... <br />... .....Number of persons in family <br />..... './......Number of rooms in building <br />The premises are to be used as a................................................................... <br />. ........... <br />The owner of the premises is ......................................................... <br />............................. <br />Theagent is....................................................................................... <br />....... ................... <br />This application, although signed, shall not be binding up,.. <br />ie City, until <br />accepted by the Su erin en Bnt of the Wate9 De tmnt. <br />8 <br />5 ed_� ........`................... <br />......Applicant <br />Accepted........................................... .19....... By ................... <br />Superintendent. <br />