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W. a. Form 6 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks 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 stated 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...._16� 1....R--��..... <br />Block......._ ............................... Lot ...... 02� d/...... Add................ <br />...................... <br />C L� _ <br />No........................_.....Jo ..._�i./..................fi...........................:!_...Street <br />The work to be executed by.......................................................................Plumber <br />State size of lap. <br />....... Tap to be inserted in the main. <br />.............. _Water closet <br />................Bath � (l. <br />................Urinals tU <br />................Plain faucet inside <br />...............Side wall: washer <br />................Hose bib outside <br />................Hose bib for building purposes d <br />................Hose bib inside <br />................Bib for stable containing... ..... ........... stall .............. <br />...... > <br />................Number of person: in family eQ "Z' -, E'e"cr2 <br />................Number of rooms in buildin <br />The premises are to be used as a ........ �y�� <br />...................................... <br />The owner of the premises is........................................................................................ <br />Theagent is...................................................................................................................... Y <br />This application, although signed, shall not be binding upon the City, until <br />�/ <br />accepted by the yt$uperintendent of the Wato Departme� A llcant <br />_ S <br />........... <br />/ PP <br />Accepted....................... ...... ..Z... .......19....... By....✓........................................................... <br />Superintendent. 1 <br />