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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 cr..ssed out <br />Everett............................. 4_-_;?..-................................. 19 <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 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 />LL p <br />Application No...............r1...Q` <br />Block ..... ...................... Lot........ 1�3....................... Addr aG JD <br />The work to be executed by ........................... <br />State size of tap. <br />................Tap to be inserted in the main. <br />.. .......Water closet <br />. �.T/ . Bath <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 />................Bib for stable containin ,................. <br />..............Number of persons in family <br />....L./. t......Number of rooms in building <br />The premises are to be used as a ................... <br />The owner of the premises is ........................... <br />Theagent is .......................................................... <br />This application, althoug signed, shall not <br />accepted by the Superintengnt of the 1kr4ter Z <br />f �O � e <br />KCG`•7164-we x> ,s'oyy <br />City Of E 3 ,,, <br />1'9TER L) A <br />upon the City, until <br />....... By....................._".......... <br />Superintendent. <br />