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W. D. Fcrm 4 1500 3-1-17 O. P. <br />.CITY OF EVERETT—Water Department. <br />Application for Water <br />All blanks must be filled in or cross d out rr11"" <br />Everett.-.____---- - -- - ---�---------_391F- <br />TO THE SUPERINTENDENT OF T E E'/ERETT PA TMF.NT, <br />CITYhe <br />les <br />tions of TherWit Witter Departm nt, fofor the use r purposes and fixtures sf water in accordance tateth d below. and regula• <br />During :he time that any of the water mains may be taken up by reason of <br />o any improvements authorized by the City of Everett, in or of any street or alley in <br />which they may have been laid, the City will not be required to furnishwater hus becut <br />the progress of such improvements to any consumer whose supply Y <br />off, or be liable for any damages for f failure so to do. <br />Application No..----- - -%--P---- <br />n / 7 ----------- Street <br />'fhe work to be executed by---------------- - ______________________ Plumber <br />Stare jAze9f tap. <br />_ e%Tap to be inserted in the main. <br />_(_ _ _ _ Water closet <br />(_ _-_ Bath <br />.Urinal <br />---_-•____Plain faucet inside <br />.________Side walk washer <br />Hose bib outside <br />Hose bib for building purposes <br />---------- Hose bib inside <br />._._Bib for stable containing ------------ stall ---------- <br />Number of persons in family <br />/- / Number of rooms in building <br />^c premises are to be used as a -- --- ---------------•--- <br />------------ ----- <br />Thu owner of the premises is __.-_. _ <br />-----------'--------------- <br />Theagent is -' ---'-----"---'--"-----'---- '------ "_ ----------------___--- <br />This application, although signed, shall not be binding upon the City, until ac- <br />cepted by Tne Superintendent of the Wit r Department. <br />Signed ---'-------- <br />y _ZZI---- <br />`_fr-.�------Applicant <br />Accepted1 -- . `� - suverin dem <br />