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W. D. Form 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett...............................1.............................19fc..i.� <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 :. which 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. /.... .3 .............. lm4o <br />Block.................. ../................ Lot.............. 6.n ................. Add ....:�.*.1......... ................ <br />No.........:.. _.. �-� —.......s .��.... W"........................:...........Street <br />fir.............AE <br />The work to be executed by ... ................... ............................ _................... Plumber <br />State size of tap <br />...���.....Tap to be inserted in the main. e0, <br />closet ..............Water <br />.....Bath <br />Urinal <br />f ................Plain faucet inside: <br />................Side walk washer O <br />..............Hose bib outside <br />-� ................Hose bib for building purposes �o 3 <br />-? ................Hose bib inside <br />................Bib for stable containi... ................. stall .................... <br />................Number of persons in family <br />................Number of rooms in building <br />The premises are to be used as a................................................................................ <br />Theowner of the premises is ................ .................................................. ...................... <br />Theagent is.......................... ........ .... ........... ............................. .......... ......... .................... <br />4 This application, althou h g e sh Il ryryryggqt be inding upon the City, until <br />accepted by the Superint�tl�i J�h 11tj rtmetyt./ n <br />By....................................... _........................... <br />Superintendent. <br />