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� <br /> r <br /> W.D. Form 4 <br /> CITY OF EVERETT-WATER DEPARTM�NT <br /> APPLICATIOI�T �OR WA�'ER <br /> All blanks m��st be filled in or crossed out <br /> Everett......................__......,::;_... ....../..��........._... __..19:,...5s�- <br /> TO TI-iE SUPER?NTENDENCITY OF EV RETTDEFhHTMENT: <br /> r I he�^by aFP�Y for the use of water in accordar.ce w:th thc rulrs and reGu- <br /> lations of the Waler Department, for purpusc� and fixturns st�ted beloa•. <br /> Purin; the timc that any oi thc watcr mains may Uc :alcen up by rcason <br /> of any imF��rovemcnts authorized by thc City of Everett, u� o: of any strcet or <br /> alley in �ch ich lhey may have bcen laid, ihe City will not be rcquired to [urnish <br /> water duriiig thc progre55 of sudt imp:'ovements to any consumer aliose sup- <br /> ply may 'h:: be cut otf, or be liable tor auy damages for iG tailurc ro to do. <br /> j � _ <br />� APPlice.tion No..l':.`y�..._..J.......... <br />• Block.._..............._..................Lol........._.._.__........._....._.. Add... ._.. ._ _._.. ._..__ .. _.... <br /> ` ` 3 . 2 �i __Strect <br /> , - <br /> xo...................._>..�...�......� -....--/..r.........._..__............---....... <br /> ._.............................................._.............................................._................._......_........._.___. <br /> The v✓ork lo be execuled by... ..........._..__.._. . . . ._.__. .__..._..... . ... ._Phunbcr <br />' Sab.: sizc of tap. <br /> I _._-�...�....Tap W Ue inserted in lhe main. <br /> ......__.....Water closet <br />, ... ............Bath ' . ,. . <br />� !� � k� <br /> . . _._.......Urina] ��;- �,b ' <br /> . ,�, <br /> .._. _.......Plain faucet insidc r '-` � <br /> _..._.._.....,Side walk washer ����11�i�`'�� � . .. <br /> _..............I�Iose hib outside � <br /> �j cv�.i�-° <br />� � .............._Fiose bib for bwlding purpoSeE�'��� " <br /> . ,,.._ .., �.�i.-�,. <br /> ........._.....Hose bib insidc �,::,., .-... <br /> ................Bib for stable containing_... ..........._st:�ll..... . ..._ .. .. <br />� .._............Nwnber of persons in family <br /> _..............NumUcr of ruoms in buildinEt <br /> Thc premises are to be used as a. ._ __... . . . .._... . .. . __ . _ .. . _.. <br />� The o�vncr of the premises is.._..._.... ................._._............................... ..._.._.... <br /> The aSent is........................... ._................._.. .__......__............_.. <br /> _ ... _..__..._._._.._...... <br /> IThis applicalion, althou„h signed, shall not bc binding upon thc City, imtil <br />�I accepted Uy lhe Super}ntende�of thr/.W�ter Deparlment. <br /> �/' � � �f.�U� ��c :-� �/��i�'�4� :1.....ApPliaant <br /> I` Siened._.1..:.V�4� /� l��,� .. .. . _ . <br /> �cu�p:c"... . . 1"... Y� .__.. ......... <br /> � �- Supcuntcnduil. <br />