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�. . <br /> W.D. Foim 4 <br /> CI'i)' OF EVERETT-WATER DEPARTMENT <br /> APPLICAT��I�i FOR WATER <br /> All blanks must be filled in or crossed aut <br /> Everett......................l.{.:;�..�.�.........._._....._._..._t 9_4.'Y <br /> TO T}IF. SUPF,RINTENDEA7T OF THE \5'ATER DEPARTMENT: <br /> CITY OF EV£.RETT: <br /> I hcreby apply for the use o[�vater in accordance with the �ules and regu- <br /> ]ations a[ thc WaL^r Department, for pw�poscs and fixtures stated Uclaw. <br /> During the timr that anY �f the water mains may bc talcen up Uy reason <br /> oC any i:nprovc�n�nis autharized Uy Lhc Cily ot Evcrett, in or of any 5trect or <br /> allcy in �•hich lhey m�y]iave becn Iaid, the City will not bc required to furnish <br /> t��ater during lhe progress of sttch improvemenls to any consumer whose sup- <br /> ply may thus bc cut o[[, or be ]iaUle for any damages [or its failure so to do. <br /> APPlicalian Nn..�P��.��........._ :�«.t��)� <br /> IIlo^k..._......._..........................Lay.......<<_...__.___._._........ Add..i�s'.r,r:�LC.:.r.'�,.,c. <br /> No...._ ��/ �' !�.^�L.t-f..�................._........_.............Strcel <br /> ........................:.__......,. <br /> .............___.................._...._........_............................._.._...................... ........................._....... <br /> The work to be executed by......_..._..___. . . . .. _ .. ..__. _. . . .. _ .PlumUcr <br /> Statc size of tap. <br /> _'.�._�...._Tap to be inscrted in lhe main. <br /> .._............�Vatcr closet <br /> , , <br /> ................Bath ��' . , 1 <br /> ,. : ,. � _ ��i <br /> ._._..........Urinal � ��' <br /> � / / <br /> ..._......_...Plain faucet insidc �V��I� .f.�` h�F��� y,j�� <br /> .__........_Sidc walk washer ' � <br /> _........_.flose bib outside '.;�.., :��I EV�:��c�; �� ���� <br /> .,,..�_,.*_ �:'1 <br /> . ..._.._....Rosc bib for building purposes �.,�,;,;r_;t t?E�T', :,: <br /> ._.............Hosc bib inside � <br /> .. .__._.....IIiU for stablc wntaining.........__ ..__sta❑.._.... ._. ... <br /> . .__........Numbcr of percons in family <br /> . . .........NumUcr of rooms in buildin�: <br /> 1'hc �remises are to bc used as a_ _. ._. _. . . . . .. .. ._... .. ._. <br /> Tim owner of lhe premises is _....... _. .. ._.. . ___. _. .. . <br /> 1';ic agcn[ is..... _...__...._ . __..._. ._........_. .....__.. ....._ _ . .. _.. <br /> 7'his applicatinn, :althnuF�� siqned, shall not bc binding upon thc City, until <br /> ❑cec lcd b� the Su�crint�r�ndenL.of l 0 W tc Depart�tent. <br /> P S I q (� <br /> Si6ned.....d�'�lv?" _� ..-.. �....E.rit-LC:. V . ._ _._.......Applicant <br /> A^_crp;c _ _... .. . _. ._..1Q._.... I3�� . . ...�� _ ._.......... <br /> Superinlcndcnl. <br />