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W. D. Form 4 150o Y147 C. P. - - <br />CITY OF EVERETT==Water <br />Apni; — <br />ErvYc r<.� o ry <br />Department <br />cation for Water <br />All blanks must be fit is or crossed nr(/ <br />Everett,.___ <br />RINTENDENT OP THE } ATpR ppRTb1ENT- <br />TO THE SUPEDt <br />CI.1'Y OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and re <br />buns of TDnri he {Pater Dapartment. (or Purposes and fixtures stated below, <br />any ❑np ovemcnts eulthor. , any <br />of the water mains may 6e taken gula. <br />which they may have been laid,' the City of Everett, m or of to up by reason of <br />the progress le such improvetneutselo tan will not be required to y street <br />e'atr. alley In <br />off. or be liable for any dmnage� for its failure so to do. <br />y consumer whose supply during <br />/ PPII' may thus be cut <br />Application No._ 4O 9 <br />Black __C ?J"'!' 77��j- <br />No. XO_ �.�/ t.i- <br />-Add <br />------- _______________Street <br />The work to be executed by_ -_ _______________________________ <br />______. <br />Stat size of tap. -" •---------_- Plum <br />ber <br />i <br />'_Tap to be laserted in the main. ------- Water closet <br />---- Bath <br />(� ------- .Urinal <br />-------- Plain faucet inside <br />\ ------ __Side walk washer <br />-------.Jiose bib outside <br />-.Hose bib for building purposes <br />---------.Bose bib inside <br />----------Eib for stable contsinin <br />g---------__stall- <br />Number of persons in family <br />_Number of rooms in building <br />The premises are to be used as a <br />The owner of the ---`" <br />premises is , ____- <br />The agent is .. --.-""--' <br />This application, although signed, shall not be bindin - --- -•----'--, -- '-•--- <br />cepted by The Superimc g ulano the City. <br />at of the Woo or er De y Until- ac. <br />Acceple ✓ r - ___19 9�+•=-----Applicant u.-v <br />• superintandenl / <br />---------- <br />Iy <br />