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� <br />a, s'L$" t'f : iH 1_'.:, � .. . <br />�r�ir`9. :P> ._, . , . .. <br />W. D. Form 4 <br />CITY OF EVERETT—WATER DEPARTMENT <br />APP�aICATI+�N FOR WATER <br />AL Ulanks must be filled in or crossed out <br />Evcrett....................._...._f`-..... �............_...............1 ) �� �.. <br />TO THE SUPEAIN7'ENDEfIT OF TFIE WATER EPARTM�NT: ,' <br />CITY OF EVERET:: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />latior.s ot the Watcr Department, for purposes and fixtures stated below. <br />During th�: tim� that any of th� water mains may be taken up by reason <br />ot any improvements authoriud by the City of Everett, in or of any strect or <br />al1�y in which they may f��ave bren ]aid, the City ;vill not be required to furnish <br />v:aicr during the progress ot such improrements to any consumei• whose sup- <br />ply may thus be cut off, or Ue liable fo!• any damages for its iailure so to do. <br />� �./ �� �/' �„�i.._:.� �/�'a._,."_.;, <br />6pplication No.._t..� ............._Y A <br />� � . .... . j� c� f ! .-lis ,/., /'- <br />.. . 1... .� '�Aa� .__ �.. ' _ <br />F31ock --���...... Lot -� . � <br />�. . . <br />No.....,x`-�-t-=-:-1= ��`��..:.:..._�icr..,.f:�:.L..i ......Strect :.. <br />........5:._r.l....�..._`?- —'>.3...:�`���`ne 7��� � <br />.................. . . ... _...................4,.:E2...................... _... _ <br />The work to be executed by_.._..._....._........_ ........................................Blumbcr <br />Stalc size ot tnp. <br />�l <br />� y..........Tsp to be insertc3 in the main Y � � <br />/l C/� j� . <br />.....�......�Vater closet � � <br />.IIuth i ��-G ;�,. ' <br />................Urinal l , <br />� c , . ;- <br />................Plain taucet inside � , -� <br />................Sidc walk washer .. , � . p� .�va-� J.,� <br />................Hose bib outsidc i ��' �' � `� � <br />,�..� i- . . . �_ <br />I v <br />................'riose Uib for building purposes !. � �. <br />................I[ose bib inside ��''. ' �� � � <br />........Bib tor staUlc containin ..slall ..V'_t',1;-�;, i:. ��. <br />.... g ..... ........ .. . ... ... <br />......Numbcr of persmi; in family .� - �,,,� �� �.� ( � , l <br />. <br />.j � .....Numbcr of rooms ir cttild;ng r ( ' c . , •-.c. �l'. �� <br />-� t i <br />T}�e premises are to Uc used �s a.. .. - <br />/ . ....,..._ u I�..,:j-u,,:.:,..(� . <br />The owner of tLe premises is.... �. j �`� - <br />. . .. . � « .............................. ... <br />. . ... �_�:. <br />Theagenl is...._.._..._ ..........................................._......._.._..........._...... <br />............. _ ... _ ..... <br />1'his appiication, although signed, shall not ue binding upon the City, unti] <br />accepted by the Superintend`y o((he µf�ter��rtment. <br />�. -✓ ✓ , <br />!Signed.....��...�'�.;_/� - iiiX� <br />..........:..:...............:........................................A ppli ca n t <br />Accep;ed.........__.._. _._...__ .............1D....... B <br />y.__...._.....__ ................. .............................. <br />SuPerintendent. <br />