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W. D. Form 4 1500 0-I-17 C. P. <br />CITV OF EVERETT-=Water Department <br />A.pplicatior� for 'Water <br />All blanks must be - 1cd ii�jn or rQW,,ed /It �,,(/�/ <br />__,/----" _----�___ __.______19------ <br />Everett- <br />To TILE SUPER[NTENDENT o CY OF CATE CT DEPARTMENT, <br />tuns of The Water Dzpartn•nt, for purposes and fixtures stated belor the use of water in accordance with the wgb ndeasonlof <br />During the time that any of the water mains may be taken up Y <br />.my improvements authorized by the City of Everett, in or of any street or alley m <br />which they may have been laid, the City will not be required to furnish water during cut <br />the progress of such improvements to any consumer whosuPP Y y <br />off, or be liable for any damages for its failure so to do. <br />se <br />%.%6?- <br />Applitntion No - <br />- _ p— U Z-- 6 Add-'---' -------- <br />Block - -/ __ -,.Street <br />No._��__4_/3--`_- -`_ ________________________ <br />--- <br />The work to be executed by --------------- <br />Plumber <br />Stale s e of tap. el _ <br />-Tap to be inserted in the main. <br />...... / .-Water closet <br />-__-- .Urinal ' <br />......_.Plain faucet inside <br />Side walk wisher <br />_Hose bib outside <br />---------- Hose bib for building Purposes ' <br />----------Hose bib inside <br />_.stall._. <br />Hib for stable containing ._.------- <br />.._ <br />_- Number of persons in family <br />-___Number of rooms in building <br />The Premises are to be used as a ---- ------------ --•-"' <br />The owner o' the Premises is ----- .---- <br />'Che agent is. _ ----- ____ ____ ___________ ._._.__I___.____________. <br />This applictub ❑, although signed, shall not be binding upon the City, until ac- <br />_. .. <br />and by The Su o cntend t Athe wetgr Department, <br />04 t pplican <br />Signed_________________t <br />Ily. ----------- <br />___.-- u etlmendent <br />