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W.D.Form 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FC'�R WATER <br /> All�blanks musl hc filled in or crossed oul <br /> Everelt�..... _.._ ��� ..�...( __.._. _]9��_v <br /> TO TIIE SUI'ERINTENDENT OF 7'ilE WATF.R DEPAATh1ENT: <br /> CITY OF EVF.RETT: <br /> I herebl' ��PP�S' tm' ��re u�c ot wnter in ncrordance a�ith lhe rutes nnd regu• <br /> Intions o( the Woter Departmenl, fur purposes nnd fixtures slnted 6elow. <br /> Dw�ing lhr. limc lhal nny of the wntcr mains mny be taken up by reason <br /> o[ nny improvements nuthnriud by thr. Cily o[ Everett, in or ot nny strecl or <br /> nlley in which they mny have becn lnid, lhe Cily will not be required to turnish <br /> water during lhe pmpreas ol xuch improvements lo nny consumer whosc sup- <br /> ply may lhus bc cut o(t, or bc liublc for nny damages [or ils fnilure so to do. <br /> ApPlication No._.�._�.-L....%.�.�...... <br /> Block._... ..__..... I.ol.._ ..�_ . .. ._ Add _ .._. . .._._ .._. . <br /> ! <br /> Na__._......... �. �....,. � ._..._ �.�..[� �z'f.__. __8lreet <br /> ..__............_._.._.........__.. _...................................................................._. ..__. ......._....... <br /> Thc work to be execaled by.. .._.....__.. .. .. . _.. _t........._.. . Plumber <br /> Stntc sizc of lnp. I,�� '� <br /> /. .�.......Tnp lo be in+crted in thc main. <br /> S( : r <br /> _..............Wnlcr closet i��.!'i, � 'i � <br /> ................Bnth �., r �'� <br /> .........._....Urinnl i . ' ,.� � , �i� <br /> ......._...._.Plain [nucet inside �;.,' � . , � <br /> .....__.......Side wolk washer <br /> .. ..........._Ilosc bib oulside ` : . •� �! ��. <br /> ^ I <br /> ......_........Hosc bib for building purposce 7l ,J .l � ' � r ' e� � � I <br /> ....._.....__(Iose bib insidc __. <br /> ..._._..._...Dib far slnblc cantnining._._...__...._.slall__._.. . <br /> . _.. . ._Num6er ot persans in tnmily <br /> _ . .__._Nwnbcr ot rooms in building .. , / �• . <br /> �_Thc premises nre lo be used as a _._._ . �C...�./��) � �.�.. . . , . ..� <br /> Thc owncr of�hc prrmi��c ic . r�rx;,.a�.-Y'��:..) ���`�. . <br /> Thr ngent is.._.... ...._. . . . _ ... . . ..�;,li.l.e.c N� ����[� �•'< r. � <br /> This nppliculmn, althoui!h cigned, �hnll n�l bc binding upun Ihe, ily, imtil <br /> nreepted by the Supc i�ndcnl nt the N'�ter Depnrlmenl <br /> SiF:n��'. ..�F�` i lz_L:l.��li__ .. ._. . _. .__ .Applirnnl <br />� A�crpird . 19.. .._ Ry_ . ._ ._ .. .. . ___ _ _.. . . . <br /> .. Superintendent. <br />