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W. D. Fo�m 4 <br />CITY OF EVERETT-WATER DEPARTMEl�T <br />f ������ � �� � APPLICA,TI+�N FOR WATER <br />� P.il blanks must be filled in or crosecd out <br />/_;� <br />Everett,.._.._ _ ..............�-.r�.:..�...:�?.1�........ _.......... _ _..... _ 19:..:. �. <br />TO THE SUPERi..I'ENDENT OF T2IE WATER DEPART3IENT: <br />C1TY OP' E�'ERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />]ations ot ihe Waler Departrncut, for purposes and fixtures stated be]ow. <br />During thc lime that any ot the waler maiu. may be taken up Uy reason <br />of any impravements authorixed by thc City n[ Everett, in or of any strect or <br />alley in which thcy may have been laid, the City �vill not be required to furnish <br />water durinF the progress of such improvements to any consumer whose sup- <br />ply may thus be cut off, or be ]iable tor any damages for its [ailure so to do. <br />Application No....,�.J`.fu.:.�,i ....... <br />Alock.................._.................._ Lot._...._.__.......................... Add......_...._._.__....___.......... <br />No ............._ � ��?�. —...../.F+�.��i.,—c ..........S�rect <br />,/�..c .. . ..... . ..... . . ..........,........................... <br />The work to bc executed bY .............._.....__._ . _.._ . _ _.._._ . _._.. .Plm, ��..r <br />Slatc sizc of tap. <br />.-./`..Tap to be inserted in thc main. <br />...... .......\Valer daset �....� <br />......�..:....IIath '� . <br />,�{ 1> <br />4 <br />_ .............Urinal ��N� ; � . <br />I. l. C'.7 � � : . <br />._......_.._..Plain faucet inside ���d�,i,)�� ��� = <br />........_.....aide tvalk washcr �i 6 � �,� <br />,,, � � � <br />................Hose Uib oulside �'�ir.� -t ...,�,. �/�" �' <br />/i :,� _, �.; � . <br />-._..........Hosc bib for building purposes ' ��-; /�� � " <br />�s ; <br />................IIose bib inside <br />................IIib for stable containing..........._..._stall......._____.. <br />.. __........Vumber e[ persons in family <br />_._eS......Numbcr of rooms in building <br />The premises are to be ised as a ....................._._.._....... _..._ ...._._ ._. __.... <br />Thc owncr of t;_, premises is ................_.........__.__........._._..._ ._..___._ _.. <br />_ _ ... <br />ThcaFent is............_.._...........__._..._......._ .........................................._..._._............... <br />This applicatinn, alti�ou�;h siFned, shall not be binuing u�on lhc City, until <br />nccepted by tl�c Superintr.ndent of [he Water Departmyep t. J <br />C `-� l <br />�1.: � .:/� �, o <br />SiKned...�_.�:. �:�1__....._. � I �.ci� ..............�...........Applicant <br />. . .. _......_. . <br />A�'crplecL..__ . _._.....I�._._. A}' ..._..__.. ..._._...__... ........._..... <br />Superintcndcnt. <br />�� <br />