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,/ - <br />W. D. F�rm 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATIQN IyOR WATER <br />A1I Ulanks must bc fillcd in or CCUSSCfI out <br />F.vcrett,..........._._... _.......,,....-.:_.:.?:./_....._..........__..__19�:..'.,� <br />70 TkIE SUPERINTENDEN7' OF TFIE WATER DEP.�I2TMENT: <br />CITY OF EVF.3ETT: <br />I hereby apply tor thc usc ot watcr in nccordancc «•ilh thc rules and regu- <br />lations o[ lhc �Vnlcr Department, for pw�po_=es and fixtures atated bcloa•. <br />Diu�ng thc lime that nny of the water mains may be taken up Uy rcason <br />of any improvemcnts :mthoriud by lhe City ct Everett, in or of any sU�eet or <br />clley in which lhey may hnve been lnid, the City aill nol be required to furnish <br />a�atcr duriug Lhc progress of such improvements to any mnsumcr whasc sup- <br />ply ma}• thus 6^ rut oft, or Uc liaUle tor any dama�es fo[ its failure so to do. <br />FSi�'_ . � . . � .. <br />APPlicalion '.Jo.,c:. �.�.:�.'..,.i ............. <br />Block......_ ............._........_....... Lot._............_._._.....__........ Add..___..._ ....._ ... .. _. <br />�_ ;_,.�� <br />No........_��.._._�°.(.j........-'_.........-......_....._.._ .................__ . Strcct <br />_ .............................................................._......._._...................._._ __ __ <br />7'hr work to be executed 6y.. .......___....._..... .. ____ ... ... .. . 1'lun�hr.r <br />S;;itc size ot lap. <br />.� ..___.Tap to bc inscrted in thc main. <br />.. _ _..__.Walcr doscl <br />.....;'.........Bath . � ���. <br />.. _..._ ..Urinal �: , �. <br />, I <br />. ._......Fiain faucet insidc � , �-, � <br />.. _..._Sidc walk washer � � <br />_..._...Hosc biU o�lside �-� � <br />_......Hose Uib for building purp�scs <br />. ._ ....__..Hasc bib indide <br />.._............DiU for sta6lc containing..._.._. ._st��❑ .. <br />...__..._....Nwnbcr o[ Pcrsons in tamilp <br />_,: t.._.._Numbcr of room� in building <br />'Phe premises are to Uc used as �.__ . . . _.. .. .. . ... .. . <br />'I'he uwner of thc premises is._..__ .. . . . _ . __ . .. . .... .. . . <br />,Phc aSent ia .............................._.._. __._._._..........._.._.........._.___.........__.._ .. . <br />'I'his applicatien, alQmugh signed, shall not bc bindiaF upon tl�e Cil>�, imtil <br />ureuptcd Uy 1hc Superinlendent of thc tVatcr D parlment. <br />� //� � <br />Siened.�� _/_. ' �-:'c.i-� n �'_,,.' � `: ->-`'.1_�I"AAPlicant <br />�1,�n�p:�,: . 1:1.. P,c.. . . . . . _ _._.... <br />S�dperintrnncnt. <br />