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t-,-.A��,_ d �� - r ,�. <br /> _, _ � , , <br /> ��' U I'orm�-Ix��n-.E.P.Co.-6.2E.R1 ' • <br /> City of Everett-=-Water Depai�tment <br /> �PPLICATION FOR WATER <br /> :\II Llnnks muet Lc fillyd in or crossed out <br /> I'.cLrCIL........__.._.__. _��.F. ..........__.1p2J./ <br /> T�� 7'lll: SU19:1i1\TI�:.CI;1•:1'P !)F TIIC 1C:1TIiR IIIiPA121'nt�\T: <br /> CITY OF EVI;R�TT; <br /> 1 hi�rrL}' .��;�ly fnr lhc u-�� u( a•nter in nccrrdnnrc e•i�h thc rul„= nnd trgu- <br /> Inlians of lhe 15ntcr llapnrlmenl, fnr ptvp�ves i�nJ fisnn�ns e:nti�d belotc. <br /> Uuring the timc lhnt nup of thr q:ttrr mnine mn}' Le lnken up Lv rrnvan <br /> nf nnp im �rurrmeule nuthorizeJ hy lhe Citp nf F;verctt, In or ot nny ntrci•t ar <br /> nlley in �e�ii��h ihry mny hnce L��en Inid, Ihr City will not bc required tn furniah <br /> w::tcr during lhe prngrese af nurh impracrmvnts ln nny rnnsu:ner e�have supply. <br /> may tLur be r�rt ��tf, on c� IinL!e I„r :.uy dmm�ges for itx tnilurc eu to do. <br /> APpI(cntinn Na . ....�.3.�._�L.._�._.. <br /> 131nck..... . . .. . I.ot . . . _.._ _ Add. . . . .. <br /> �n._� �..c.`' .. y� _ '."' / ........3t�CCt <br /> /0 n l/ <br /> �.�--c��-UL✓ <br /> . . ..... .. ... . ....... _ . .._ _ .._`..._p�� ... .. .. ........___ <br /> 7'he work to Ue execuled 61' ��--�—R-'�-�( � _� ..PlumLer <br /> Flnte eir.e of tnp, �� <br /> ���..��...._Tnn ro Fc (nserted in thc mnln. <br /> .. ../...__R'nler claset � i � <br /> .../..........Onch I I _.. <br /> .- ......._IIrinnl 1 <br /> ..<�.-: ..Plnin fn��ret ir.idr <br /> ...'.-..-.9iJc wnik n'mhr; <br /> .��-.......11onc LIb oulr�ide <br /> . _ .....:..Hnec biL lor 6uiLiing pnrpn��.. <br /> . �. .-...::..11nsc Lib inslda <br /> _ . �' ) <br /> _....__......DiL far etuLlc contnining...____.........xlnll...._ ./ . .. . <br /> ......_........Kumhcr o[ prrxons in fnmily <br /> �._....Numbcr of ronms In Lnildinq � / <br /> 71�e pretnleex nrc to be uecd ne p-�. �L,��C� [ ..i... �..._� . <br /> lI _ <br /> '�r� mvner of lhe premises is �.� ,.. .,: � . 1,,_... � ... <br /> :��c ngcnt {e...... ....__....... _. _... ..... __._ . .. .. ._�.._.._. .. .......__. <br /> ;plicnllon, althnu�;h nigned, shnll not bc binding upon lhc Cily, until <br /> ��Y �hc Supu�lntc��fnt nt th� Nntc �Uc rtment� <br /> Sl6ned.......�CI�OLz�e c�!_� ��.a��� �' <br /> ..... . . _... Y . ........ .__...: Applicant 1 <br /> � . Y � <br /> .1e� t�.� ....... . _. _ .. .._IOP..:... D �...... � <br /> . .. .. ._.._.... � <br /> 4uprnnlenJent � <br />