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/ .,K-' <br /> W.D. Fo�m 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> �� �_.,:� �' .......................19_........ <br /> ...�: ........... <br /> F:vcrc tt............................. . <br /> TO TIjE SUPERINTENDENCITY OF EVER TTDEPARTn4ENT: <br /> I hereby npP1Y for the use af �vater in accordance with the rules and regw <br /> During thc lime ihsl any o[ thc watcr mains may bc taken up UY reason <br /> lations o[ lhe Water Dep�rtment, for purposes and fixtures stated be ow. <br /> o[ any improecments aulhorized by thc City of Evcrett, m or ot any strect or <br /> watcrduring�thc p o�gicss of cuch inpi�ovemcnls to� anyconsumcra 1 osersup- <br /> ply may lhus be cut oi[, or be linUle�or �ny damages [or its failure so to do. <br /> r, ' / <br /> �pplication No.....�f..._�/�........... �... "�� ,� ���7 �-1 <br /> ,_,�%:��s�..(.C.r--tC-C-li' � <br /> ...... <br /> Slock.......................................Lol.....:........ ......../................ <br /> ................................... <br /> /�� 3I.�..........C..��.....J:. .........Street <br /> No...................../........... <br /> ... `i u.- zt.�..............._. <br /> ............... <br /> ......................................................................... <br /> ...................... <br /> ........_.._...._..............._......Plum cr <br /> The work lo Ue esecuted Uy..--�������--�-���--' � <br /> Statc sizc o[ tap. <br /> /.__�.�.....'Pap lo be inserled in lhe main. <br /> ................N�atcr closet <br /> ................R a t h <br /> ...............:Jrinal - E�. . <br /> ................Plain fuucet inside �,' . , '. <br /> ................Sidc walk washcr <br /> .....Hosc Uib culsidc , <br /> ,,._...........Hose bib for Uuilding purposes ��j, (�/,Pi�� <br /> r/ / <br /> ................Hose Ufb insidc - �!� �, " <br /> . . stall._.......t.�..4'��t <br /> ................Bib icr slable contammg...........J.,.. —� �/.�_ .,'__ <br /> — � <br /> � Numoer of persons in family- �: �� �Y <br /> ........_...... � Jd =✓�« ..� <br /> . ,.._,........Nu�nbcr of rooms in building ^ <br /> � ���:cR.rcC�£G,....!�', <br /> The premises are to Uc used as a..................._.................... <br /> Thc owner of lhe Premises is................_..__....._..__..................._............... <br /> ............... <br /> T;�e abrnt is......................_........ <br /> ...__. ......_....................._...... <br /> .__...__........_..._._........ <br /> Tl�is al`P��cation, althou�;h si nCd, shall not hc binding upon the Cily, until <br /> accepted b;� the Super til ��t pthe \Vater Deparlmen[. <br /> . � // � <br /> �w�i.�........................._................._A P Pl i c a n t <br /> SiFncc .�..... . :`;L�.i. .. ............... <br /> .._...19....... c.__. ........__.._ ... <br /> ......_ .._........... <br /> elceeP,ed_.__ _ __ _. . _..- SuPerinlendent. <br />