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/�,�.�� <br /> W.D. Form 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All Ulanks must be fillid in or crassed oul <br /> Evcrett�.........__...............J.:.::-, ;.s-.%�%._..........___..._19 5�.".. <br /> 7'O TfiE SL'PERINTENDENT OF TIjE WATER DEPAIiTn1ENT: <br /> C1TY OF EVERETT: <br /> I hcreby apply for i6c use of�vatcr in accord�nce wilh tl�c rules and regu- <br /> ]ations of the R'atcr Deparlment, for purposes and fixtures staled below. <br /> During thc timc thal any of thc watcr mains may bc taken up Uy rcason <br /> of any improcemenls auqiori�ed by lhc City ot Everelt, in or of cny street or <br /> allcy in �ehich thcy may havc bcen laid, the City will not Uc required to furnish <br /> �eater during thc progress ot such improvements to any consumer whose sup- <br /> ply may thus be cut oft, or be liable for anv damages for its tailure sn to du. <br /> ��PPlication No...�.�..�/..�i%' <br /> ...................... <br /> IIlo ck..........�.E....... <br /> ........_....Lot.. ./. f'.._�.r.,2'.._..... Add...�'�.r.c..f�:.c�✓`�=.=�.!_-� <br /> No........ .........:�s�.:.'.�'.....F=/f-�..?-£ctn-,..A._........_........_......._Strcel <br /> . ... ._......................................................................................._...................._ .__..._............_.. <br /> � Thc work to be executed bY... ................................_.....__.__. ... .._.... .. Plumber <br /> Slab� ize at lap. <br /> .. .�J.��...Tap to bc insa�ted in the main. <br /> ., , ..._Watcr doset / ��i/' <br /> , �-"..'�.....IIalh �{7"/ �L . <br /> . ...._.......Urinol � ,�(' �� . � ". <br /> r , ��� .. <br /> .._........_..Plain faucct insidc . �� <br /> � ' � <br /> ..._...........Sidc u•alk washer � / ��" i"i <br /> �: <br /> ._._.. ......Siusc bib outsidc . . _.•.:;y�' ,y�- ��' <br /> .._............Iiosc bib for building purposes � �l <br /> YI i,�' .. <br /> ........_._...Hosc bib inside j� / 'r`, <br /> ................IIib '.or stablc conlaining...._..............stall____. ._. ._. ^', �, <br /> . _....__..Num6er ot persons in tamil�� <br /> . . i�....Numbcr ot rooms irt huildinti <br /> The Premises are to be uscd as a.._._. __._ . . . .. . .. .._ ... . __. _.._ . .... <br /> Thc otvner o[thc Prrmiscs is......_._..._.___._.__......_......._...___ .._._...... ............. <br /> Thcagent is__........_....._.....__. __.. .. ........_..__....._...._............__._..........__..__........ <br /> This applicalion, althouFh siFncd, shall nol bc binding upon the City, until <br /> ;�ceepted by the Superintendenl of the Nater De�artment. <br /> �'" 'i _' <br /> SiFned.�-r'.0.............�'�..`..T�c4<."°"'-�' .Applicant <br /> r.- . ...../ . ............. . <br /> A�,ce�pted.__._ .._ ..........................1�....... BY.................................................................... <br /> Superintendent. <br />