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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......................... <br />...................................�.'�a-..............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 />Application No ....... /... i ��„d.G! . - /A - <br />Block........................................ Lot ...J}L�..�..3,.}. ....... Add ........................................... <br />No............................ .......... ....1..�...-.....,2`.....U.t...............................Street <br />The work to be executed by........................................................................Plumber _ <br />State size of tap. <br />Tap to be inserted in the main. S <br />�`.......... PAD <br />......Water closet <br />................Bath Ann <br />................Urinal 1 �`<` % r <br />........Plain faucet inside <br />................Side walk washer <br />................Hose bib outside A —A!_, �° a <br />................Hose bib for building purposes 3 GY <br />................Hose bib inside <br />................Bib for stable containing .................... stall .................... <br />................Number of persons in family <br />...............Number of rooms in building � <br />The premises are to be used as a.. ................ <br />The owner of the premises is ............................ 61.4....... ..l.C..e_ - <br />The agent is.................................. ............... <br />.....rY't%xe$,1e✓0.........y'...... <br />.... <br />This application, although s ed, shall ypt be binding upon the Cit until <br />accepted by the Saporta of fFtjr Wryte De rtment. <br />