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w. D. Form 4 1500 3-1-17 C. P. <br />CITY OF EVERETT==Water Department <br />Application for Water <br />All blanks must be filled in or crr ed out <br />Everett,._ <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 regain. <br />tions 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 of <br />{ any improvements authorized by the City of Everett, in or of any street or alley in <br />i which they may have been laid,�the City will not be required to furnish water during <br />i the progress of such improvements to any consumer whose supply may thus be cut <br />off, or be liable for any damages for its failure so to do. <br />r/ G <br />Application No.___/ _-___ <br />' Block aa._�_Lot.___f_�_ <br />--.__. _...___..__ _.------- <br />Street <br />The work to be executed by ---------------- --.--- <br />-------'-----_-_- Plumber <br />State ize of tap. <br />--Zy_Tap to be inserted in the main. <br />----- f ___Water closet <br />--- �.... Bath <br />-------- rival - . <br />-_---- Plain faucet inside <br />---------- Side walk washer <br />---------- Hose bib outside <br />---------- Hose bib for building purposes <br />- <br />---------- Hose bib inside <br />-------_ Bib for stable containing 8----___.___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 .... <br />The agent is <br />This application, although signed, shall not be binding upon the City, un 'I c cepted by The Superintendent of the Water Department. <br />Signed <br />.__.___._.Applicant <br />Accepted.__6__ 1 <br />SOCerintendem <br />