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-> . <br />N'. D. Form 4 � ' <br />CITY OF EVER=TT-WATER DEPARTMENT <br />APPLIC�..TION FOR WAT�R <br />All blanl.� must Uc filled in or crassed out <br />F.vcrc t. ._i.<.�,,.. ;,- � :...............1�J_�.-..c" <br />' t .............._........ .....__...:....._.. <br />TO Ti3E SUPERINTENJr:NT OF THE WATER DEPARTn1ENT: <br />C?TY OF EVE:RETT: <br />I hereby aPP�Y for the use of �vater in accordance µ�ith the rules and rogu- <br />lations of Lhe \Vnlcr Department, [ur pwposes and tixtures staled hdow. <br />Uw�ing thc time that . n.� of the water mains may bc taken up Uy rcason <br />o( anp improvemcnts authori�.ed by the CiCr of F.vcrett, in or of any street ur <br />alle�� in tvhich thcy may have ne^n l:iid, ihe City «�ill not be required La turnish <br />�vatcr during thc progress uf :�uch iuiprnvcinenls la anr consumcr �ehasc �up- <br />ply may thus be cut of[, or bc liablc tor :�uy damagcs fur its faihire sn tu do. <br />1�PPlication No...;�.:'..-:�:c...:_'...__..._ .. <br />Blodc....................................... LoL....__. .. . .. .. .. Add... . .. .... <br />No. .. .........✓.....�,_—?..a;.....L..:_zL.�...... .,.�:�.,_,.. �.._._..__.__ _...........__. .Strecl <br />.................................................................................... . ..................................... <br />'Phe wm�k to be executed by .................._..........__........_............_. <br />Stnlc sizc of Wp. <br />_..'�.:i_.Tap lo bc inscrted in thc main. <br />.._............Walcr doset i ,� : <br />....�._....IIath . r <br />i <br />. " ,�� � `. <br />..__.._...._Urinal � �, lf, �, <br />�Y <br />__............Plain faucet inside <br />.._.......PlumUcr <br />.._............Sidc walk washcr h 5 �E•.; <br />..._...........liose bib oulsidc "� � � <br />._ .............ISose Uib for building pm'posrs .��%� tY�°� <br />........Ilose 6ib inside ��AEI_7. . <br />.. .._........Bib .or staUlc containing..._.._......__.s;all.. _ _.._.. ._.. <br />..._...__...NumUcr ot persons in tamil5� <br />. . � ' _....Numbcr ot rooms in Uuilding <br />,r <br />'I'he prcmises are lo Uc used as a..._.__._.__ _. _. . . _ .... . _. .._ .. <br />7'iie otvncr of the premises is... ..._. .. . . __.. .. . .. _.. _. _ .. _ . <br />'I'hc agent is__......_ _...__. ........._. . .._ _ _ ..._.. <br />.. _..... _.. . _. <br />'I�his appli�•utimt, nllhnu�;h signed, �hall not bc bindinF upnn thc Cil)•, cntil <br />:iccepted by the Superint�ndent.s�i the W�ter U��rtment. �. <br />�,.� �� <br />Si�nefi-._.�_.a�.'.\... �.�4:._._�Jl-.5s�2C,:' _._. _._._Applicant <br />Accrp;ed . . ._... .. _. _...._1P.. . I3S_.. . . . ... <br />.....__ . . . ........... .._. <br />SuD��'intcndenf. <br />