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r�; <br />W. �. Form 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLTi�ATION FOR WATER <br />All blanks must be filled in or crossed out <br />`�:. .; .� . : ...........................196:". �:.. <br />Everett,........._ .............._...._.._-.._..� . <br />TO TFiE SUPERINTENDENCIT�Y OF EVERETT DEPARTMENT: <br />I hereby apply tor the use of water in accordance with the rules and regu- <br />lations o[ lhe Water Department, for purposc; and fixtures staled below. <br />During the timc that any ot lhe watcr mains may be taken up by rcason <br />of any improvements aulhorized by the �tty ot Everett, in or of any street or <br />allcy in which they may have bcen l. id, lhe City will not be required to furnish <br />plytm.yUthus be cut of[So�be ]iablef orV ny damages for�itsUta lure�so to do. <br />Applicalion No....F..�..t...�. �✓ ................. <br />�� <br />Block......Jl�.�.� ..................Loc../.�::%Y_-��.-:�c........ naa.....<yt.:;.•.f�............ <br />t7o............�` '/-kc�. f .......Slrect <br />�.. <br />. - ........... .. <br />� .................................... <br />...............Jl �. y............................ ................................................................................ ..... <br />Tl�e work to be executed by ................._...._........... ..... Plumber <br />. ..__ ............... _.... . <br />Statc sizc of tap. <br />.. �._.......Tap to be inserted in the main. <br />................Water doset � <br />✓ r <br />................Beth . �;,, �,., <br />................Urinal � � � <br />; � `// / <br />.....Plain faucet in.;idc ' <br />........._ .. / <br />................Side walk washer ���1 �,N �� � N <br />, n, <br />............._.Hose bib outside � _,/1 � ` u <br />.._............Iiose bib for building purpas?s - � �/ �, <br />. !r <br />................Hose bib inside ' <br />.._............Bib for stablc containing ..:.................stall.._.�........_.... <br />....._.........Numbcr of persons in family � <br />_.._.........Number of rooms in building <br />The Premises are to be usrd as a...._ ......................._..____.._..__..__..... __...__...... <br />The o:vncr ot the Premises is ................._..............._..............._..._._........_ ._.._.__.. <br />Theagent is ..............................._.____.._._................__....._..._................._...._..__..... <br />This application, although signed, shall not bc binding upon thc Cily, unti] <br />acceP<<� by the Superinrpt ndent 9f� t�ie�7� fter Dep�rtm'e/n�t. / <br />� (�lC�TJ�-T" p ' , <br />Signed.�:.�..... i ��..^:.._?t#..'......�.(.�..V.J.� ' {llcqApplicant <br />f r��._.. <br />Accepted......._. .._.._._._....._____`IP._.... By ............................._..._.............................. <br />Supermtendenl. <br />