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� W.D. Form 4 1500 3d-17��P• eC`me�4 . <br /> CITY OF EVERETT�-=N'ater Dep�= ���� � <br /> Application <br /> f.or Water <br /> p11 hlanks must be filled�n�t crossed����t <br /> � �� q <br /> -'_"'________"_ <br /> - !. ___-_-__791 -.-_. <br /> Everet6_---- . <br /> '[O THE SUYF.RINTENDEh'C OF THL'WATF.R DEPARTMENT, <br /> �11'y pp E`1ENtiTT: <br /> 1 herebY�PPIY f���the use�f water in accnrdan�e wilL lhe �ules and reRula� . <br /> b reason ot <br /> tims of The W�rer Dep��tmznt.fur Purpnses and fixlures statcd�s rcet ��r a11rY in <br /> :�nY imP��vementscautl�ur ied hp the City ut E crens,n�or�f��nYn uP Y <br /> thus be cut <br /> which theY maY have becn I:rid.the Citp will not be required to furnish wa[er dunnp <br /> nif,nr�e Isahlc fur a Y dan�Ke.s for its�f.�ilure so to A°„'�5e 6�����•� m�s 1 <br /> '7 2 l .�---- - - � � <br /> APPlicn[ian Nu."'"-"-'� - " <br /> li6xk __.'_ .____:Lot-..__.__'._.__.._..Ad ....._ <br /> .'_'_"'_' _ _ <br /> _-_-_ <br /> ---f 0..'�_�.--��-- ...Strect <br /> _. _ _ <br /> No._. . _ . ____ <br /> _.__' <br /> '__"'____'__'_""_" <br /> � _ ' <br /> ._-......_...__" � '.____.___._..____'_' Plum cr <br /> 'fhe wnrk ta be xecuted bY-----------"-� <br /> $^afc si2e of L•�p. � _ � � �Z D . <br /> tl/,�_____'Tap t�h�'inserted in the main. <br /> '__'_____Water doset . <br /> -__"'.'-.Nath � <br /> __"'___ .Urinal <br /> '_'_"'_'__Plain faacet insidc <br /> _ _.___.SIdC N'���t H'�F�1Ct <br /> ._.___._Ilose bib outsiJe <br /> _'_"__'__'{;ose bib for building P���1""�` �, <br /> -'__"_'_Hnse bib insidc <br /> __'__""'dib fnr stablc containing.--------- <br /> .stall _. _'-" <br /> __'_.__"_Numbcr of pers��ns in f a�nil�. <br /> _ __,___Number���rmims in��uilding <br /> -- ...._.._._'__'_'__"' _ <br /> "fhe Uremises arc to Uc used as a -------'-" _'_'__,_____ <br /> " <br /> __ <br /> ._.________. <br /> ThemcnerofthePremi<cs�s _.___.____- ._._______-.___.___'.. <br /> Thc agenl is ---'--.. <br /> This apVlication,�IthouFh siFned,sLall not bc hindinK uP'>° the City. until nc <br /> cepted bY The SuP�rinlendent��f the Nnler Deparlment. <br /> � " .__"___'-APPlicant <br /> "_"_ <br /> _ _'_.. <br /> _'..__"'-- <br /> Signe _'---" . <br /> _ <br /> '_ <br /> AccCPted ._._. .____'.191 It)'_'-"'-- <br /> .'-"_' ' � Suterimeneev <br /> - '� <br /> . . . , , . , ,� r, �,. <br />