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tl ' <br />`y <br />It <br />W. D. Form 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks rust be filled in or crossed out <br />Everett,... .. .. ....., .__.._—.............. <br />TO THE SUPERINTENDENT OF THE WAFER 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 staled below. <br />During the time that any of the water mains may be taken up by reason <br />of any im rovements 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 progrria of such improvements to any consumer whose sup. <br />ply may thus be cut off, orbeliable for any damages for Its failure so to do. <br />Application No........ .......... <br />Block........................................ Lot .......... ;�'..1--............. <br />. Add_%...`...:.�.'..��_c.�•..::.%.�.. <br />No............... :.''..r'.y::..._........`.�:...... .......... ..... .. ................Street <br />.............. . <br />................................................................................................................_.................._........... <br />The work to be executed by ... ...... .......... _........... ... ........ ........ __............Plumber <br />Stale size of lap. <br />...y....Top to be inserted In the main. <br />................Water closet <br />................Bath <br />................Urinal <br />...............Plain faucet Inside 'O0 <br />................Side walk washer &� it` j� . I <br />............... Hose bib outside <br />building Purp <br />................Hose bib inside �rip�l?_tle 0 Ptvop ,.,c <br />Cps. <br />................ Bib for stable containing .................... etall...�..®........ <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, althnugh signedd, shall not be binding upon the City, until <br />accepted by the Superinteri4ent oMhe WPter-D'parfdent. <br />Signe I .....Applicant <br />Accepted. ....... ............1.10....... By .................................................................... <br />Superintendent. <br />