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W. D. Form 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />.?.ii blanks must be filled in or crossed out <br />Everett..........................................................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, <br />er�or be liable for any damages for its failure so to do. <br />Application No ...... �..`:..._.�...��..... ' <br />u .,�.j c/u L <br />Block.... ......... 2.1 ............... Lot, ....... ,�..�.. �.-..�/�a............... ............................ <br />No .................... �� ............. i�.t�.........�) ..:....................Street <br />The work to be executed by...••.................................••.............•.............•..Plumber <br />Statfsize of tap. <br />nn <br />� ......Tap to be inserted in the main. <br />.•Y1i' <br />................Water closet <br />q' <br />................Bath <br />r qR <br />�"����f <br />................Urinal <br />Vy�'7c Zc� I�f <br />CI"Y 6 <br />................Plain faucet inside <br />walk washer <br />e"EIv �� o <br />.wAT,"R <br />................Side <br />(� � <br />A' <br />................Hose bib outside <br />................Hose bib for building purposes <br />................Hose bib inside <br />................Bib for stable containing .................... <br />stall .................... <br />...............Number of persons in family <br />. � <br />..........Number of rooms in building <br />/f/ 7 <br />The premises are to be used as a................................................................................ <br />The owner of the premises is........................................................................................ <br />Theagent is.................................... .............................. <br />................ .................................... <br />This application, although signer„ shall not be binding upon the City, until <br />accepted by the Superintendent of the Water Department. <br />Signed, <br />...... p.l./................LL..�4f,r.� <br />.................Applicant <br />Accepted............................................19....... By.................................................................... <br />Superintendent. <br />4 La£ e2F�4"tu Jrrl <br />`i+'I`taae�ar `_'+. b'3ft� t 4 yy„::'fb{.a anii%h <br />