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� <br /> W.D. Farm 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> � APPLICATION FOR WATER <br /> All Llanks must bc filled in or crossed oul <br /> '-- ,{ <br /> ,' , . . .19�''.�i <br /> Evcrclt�.. _.. _ . � .✓ :- . .r�..�'� . . . .. <br /> 'PU TI14: til'i'F.RINTh:NDENT OF TIIF. �5'ATF.R DEPARTMENT: <br /> CITY OF EVF.itETT: <br /> I hrreby npply for lhc usc uf a�atcr in aernrdnnce tvilh thr rules nnd regu- <br /> lations nf lhe Water Depnrlmenl, fo� purposcs and tixlures stntcd bcluw. <br /> Durin� thc timr that any nt thc watcr mnms map br lnken up by ^msnn <br /> of any �mprnvrments .�uthorized by lhc City ot F.vrrelt, in or a[ nny slreet or <br /> nlli�y in v�hich lhcy mny have hcen Inid, lhe Cily will not bc required to fUrnish <br /> �e;����r durinp lhr prngress of such intprovcments ln nny consumer whnse sup� <br /> pic �nny lhus bc cut o[f, or br liablc (or any damnqes for its (nilum so to do. <br /> .-: :• ,_ <br /> :lpplicalinn Nu../_. _._.._ _.:_...._.. . <br /> Rlock ._.__ ...___._... _Lol__.....�5 '�. . . ... Add... ::z.al:<<.:...' . .'��� -�. <br /> ...�. -'- ' - <br /> N��, . •.:.._._`'.�r,�.,^,!c,••.<-n..... . . .. _. ... Slrcel <br /> - .l �j � ... ._ . <br /> ' .:_. .... ._ ..... ..__... .._......._ ___... .._. ...... ...... . <br /> 'I'he icnrk lo be cxceule.3 bp . _ ._ Plumbrr <br /> t:t;,t�• sira nt tnp. <br /> Tnp lu be inscrted in the main <br /> 1N;�tcr t9usel <br /> 13nth � <br /> . . .Urinal � <br /> . . ._.Plain fauml insidc - ' � <br /> . . . .Sidc walk washcr �^'.��^ `/( / ➢� i- <br /> ' IIose bib oWsidc � � , <br /> 1losc 6ib for buildin � <br /> g purpnses <br /> Ilnsc bib insidc <br /> .i3ib tor stablc conlaininF- .a:ill <br /> . Numbcr nt Prrsons in [amil�� <br /> humUcr nf raoms in buildin�; <br /> 'Piir prrmises are to be u�ed as n_.. <br /> 'I'hr u�cncr uf Ih�, pr�miccs is . <br /> .�.�ic ngenl is . ._ . . . .. . . . <br /> '1'his npplicntian. ulthou;;h si�ncd. shali not bc bindin� upan thc Cil)', uniil <br /> .������pt��d 6y lhe Suporint��ndrnt n[ thr R'ater Deparlment. <br /> Si{lned .. . . . .. � - .. � _ Applicmil <br /> � :\��,,�p�i;l I^. R}� . . <br /> tiuprrin'rndrN. <br />