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_ -, t,= <br /> , � � �� , <br /> W.D. Fo�m 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanic, must Uc tilled in or crossed out <br /> Evcrett.....___...... .....�.•c .. ..:��.�_.�..__.................._.19�'�. <br /> TO TlIE SUYERINTENDENCITY OF EV RETT DF.P.4RTMEN'T: <br /> I hereby apply for the use of water in accordanee with the rul�s and regu- <br /> lalions af thc \Vaicr DeP���tmenl, for purposes and fixtures staled Udow. <br /> During thc timc lhat �ny of thc watcr mains may Ue taken up b}• rcason <br /> of any improvements authorized by ll:c City o[ Evcrelt, in or o[ any street or <br /> alley in «�huh lhcy may have Ucen laid, the City will not be rcquircd to furnish <br /> waler during thc progress ot such impravcments lo �ny cansumcr whose sup- <br /> ply may thus be cut aft, or bc liable for nny damages Cor ils L�ilure so to do. <br /> , . ` � <br /> Application No._.��f�..L-��..........__ � <br /> IIlock.__... ... . Lot.._ _ ...... Add .. ._. _ ... __.. <br /> .. ..... / ....... <br /> � /J - /� /" ...Strcet <br /> No ...... v,. .�.F I .. . (f -�G t. cr..C.r ......__.. <br /> ..........................................._.._......_._........................................................._...__....._..........__... <br /> The �cork to Ue execuled by... __........ . . ...�....�..-P1umUer <br /> __ __ _P <br /> S!atc sizc of tap. � �� <br /> r�. '......'Cap to be inscrled in lha main. <br /> �_-._......_AVater doset t���l � ��J. r'I <br /> _..Dalh <br /> ._........ ' <br /> _.__._.....Urinal Ci(}' oL�.r:ff-z.r J1C <br /> ._.........Plain faucet insidc �1��'f�TE�=: ;_;_�:�� A • <br /> ... . tZ S C'�,3 <br /> . _. .._ .Sidc walk washrr <br /> .. ...._....Iinsc Uib oulsidc <br /> ..._._.....Hosc bib for Uuilding purposcs - � � �� f�: <br /> . . � .� . .. r / <br /> ...__........IIose bib inside . � <br /> .... . ........Bib for stablc conlaining.___......_.....stall_.._............._lt�cc c < `-- <br /> .. _....Numbcr of persons in tamily y <br /> .......Nu�nUcr of rooms in Uuilding ��''- << ' �j°'�-'"' HJ�L <br /> 7'hc premises are to bc uscd �s a _.... __._.. ��y �!����<G���` - <br /> 'Phc awncr ot thc premiscs is ....-... ��,r��°><* !�" .la. <br /> 'Clm agenl is.__.. .. . .... . ............ .._..._.__... ................. <br /> ............. .. __........_.. . <br /> '1'h°s application althnugh siFned, �hall not be bindmg upen the City, until <br /> :iccepted bY the Sup ��'���'«'�ter Deparlment <br /> Sign �..�_ �k'�� Applicanl <br /> Accop:ri . . . .. _ . _ . .. 1P. .. I y . ._. ... ...... ............. <br /> Superintendent. <br />