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_,� <br />W. D. form 4 � � s�� <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must bc filled in or crossed out <br />Everetl,..__.._ .................c.: �.' j:....c...5...........__._...... _....19 '...�'. <br />TU TIIE SUPERINTENDENCITY OF RVERETTDEPARTMENT: <br />I hereby apply for the use ot waler in accordance with the rules and regu- <br />lalions oC thc Walcr P.epartment, for purposes and tixWres siated below. <br />Durin� thc limr that any n[ the water mains may be takr.n uF bY rcason <br />o[ any imP�'ovements author�ocd by thc City of Evcrctt, m ur of any strect or <br />alley in which they m:iy have bcen laid, Lhe City will not Ue rrquired to (urni;h <br />water durinF the Grogress c f such improvements to any com+umer �:�l�ose s�p- <br />ply may ih.us be cut cf[, or e liaUle for any damages tor i's failure so to do. <br />_ <br />Application No..__:'.i`...�... °_./._._._. <br />" "� _....... Add. .. <br />Block__..._._.:_' �/.....__ .I.oL....__' .__.. ._. .. .._... __. <br />• '. ' � <br />No..._......:.:..'.�'. _:.........✓l..!.l�x.tz�-s_........._...._.........._.___...Slrcet <br />The work to br execuled by.. .....__.._._........ <br />Slalc e.�o u[ tap. <br />,-:�s..:_.7'ap to be inscrted in the main <br />. . ... Nater doset <br />...�. . . ..11alh <br />.................................. _ ..... <br />._.._.....__.....__Plumber <br />(�i <br />% �, <br />; <br />� � F� �'i <br />_--.....__..Urinal �d � �,p� / � 7 <br />i <br />_......... <br />_...Plain faucet .nsidc ^��� � / <br />..___.......Sidc walk washer '�I�� Z �_� `�.�� �/ �,� ��: <br />�. � <br />.....Aose bib outsidc /' . <br />...]?ose Uib for building purposes ����Y �� EVr�;"; � <br />__.. H'A1ER D <br />............Anse bib insidc EPT. I,.i <br />......._......I3iU tor slable containing_ .................:�tall.._._...._ _.. <br />. _.....__.NumUcr o[ Persons in familp <br />_ '.;.........NumUcr of rooms in building <br />Thc Pi'emises nre to be used as n..... ..._ _ . . .. _. . . .. _ .. _. ._. <br />The owncr ot the P�'emises is..._ __.. . _ _ .. _... .__ .. . .. ... . . _. <br />ThcaSent is_........_. .. ........... ..._._.. ...._ ....................... <br />This appl;cation, althou�h signed, shall n L 6c binding u�on thc Cily, until <br />acceptcd by the Superinlmdent uf the Water Depart ent. <br />SiFncd._.. �%�-'_�! �/..o,)it. z. �.�,r-/� >.-i APPlicant <br />. _.,�..._. <br />A. crpte(�. . . . . . _ . . . 1^. .__ I3c. . _ _ . . . . . . . . �. _._..__ . __..._. <br />Superinlcndcnt. <br />