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W. D. fcrm 4 <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett................................ . . ......................................... J <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 whic 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......... <br />,/�1...�/��....``...... Block ....................................... Lot..... �•.......................... !Add.......p ............ T. -2. <br />No ............................ /�..0...'..... `4: 2.....�`.�..... �. treet <br />The work to be executed by... .................... _.................. ............................ Plumber <br />State size of tap. <br />.. ......Tap to be inserted in the main. <br />................Water closet <br />3...............Bath r S ri c <br />................ Urinal <br />................Plain faucet inside <br />............... Side walk washer <br />................Hose bib outside <br />................Hose bib for building purposes <br />................Hose bib inside <br />ri �X ?C-13 J `f' <br />.JAt' <br />City of Everest -74e <br />WATER Pfu- slat S O 63 <br />................Bib for stable containing .................... stall .................... <br />n <br />................Number of persons in family <br />.......... Number of rooms in building <br />Tyremises are to be used as a.............................3./..<../..`.`�F..:..e$hrC�,y�.� <br />The owner of the premises is ...................................... f.,,.,t.ax.G,.........(/......... <br />Theagent is...................................................................................................................... <br />This application, although signed, shall not inding upon the City, until <br />accepted by the Superinte�_gnopt of the Water Depa ent. <br />Signed'..../...!.�t.^il �. Q • ..........Applicant <br />................................................... <br />Accepted............................................ID....... By.................................................................. <br />Superintendent. <br />