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z.��o �-22—�; ir �� � <br />r�-.��; 9-,5-� ; �r <br />lY. D. Ibrm q—I640—E.P.Co.—�26.2.1 <br />City of Everett�--Water Depai�tinent <br />'1 � ��ATION FOR WATER <br />All Ulanks must bc fillcd in or cro,sed out <br />� c�/ � <br />. �vcrclt,....._... _........ /.... ...�._� .. .. .. . . . . ..........19'?..7 <br />TO TI1� SUPI:P[nTENDrNT pF TII� R�A'fI�:R DEPAP.TniGN1': <br />CITP OP IiVP1iGTT: <br />I hereby app]y tor the use at �t�ater in acconlnnee with the rules nnd regu- <br />lations of the AVater DeJmr2ment, tor purpo�es and fiswres stated 6clow. <br />lluring Lhc iime that :my of the �catm� mains mnp be tnken up by reneon <br />of nny improvcments authm•ired Uy the City of Gcerett, in m• of mty strect or <br />alley in �vhich +hep m;iy hnve bem� la�d, thc City wiil' not be required to fnrnish <br />water durir.g th.. m�o�ress of such impro��entents to any cuesumer tvhose supply <br />m�p thus be cut n;`, opr 6c liable for any damages Cor its failure so to-do. <br />Applicatian I��r.._4..Z S^Z �fz � � <br />k31ot6 7 1 <br />..... . .. ot..� <br />� ....__... ...... Add <br />. . .. ....._ _ _ _ ... ... .. .... .. <br />," �S-/ - � ..Street <br />__... ....... <br />. ..._.... . . . ._ ......_...._. <br />The �eod: to be executed by.._ � <br />.__.. o ._... _._.. ..PlumLer <br />Stnte size of tap. /,j � � ...... . <br />...���.7'ap to bc inscrted in the main. -'.' ; ..� <br />.......I.......Natcr closet , �-"r,r • , <br />__...�..._..P,n[h �. . <br />........ �.....Urinal ,. . <br />..._�_..Plain fnucet insidc � <br />..._...-.--....Side �ealk wn�}�cr <br />--...J.......IIose bih ouCside � <br />-._..._—..Iiosc bib for building parposc, <br />-- -....�:..Ifose LiU insidc <br />........_�Bib for staLle containing ................._stall..._......_.... � <br />�-��---.--..NumFer of persons in fnmily <br />......�..-Numbcr af rooms in buildin;; <br />The premises are to be used as � ___..� • <br />" . .. ... .. ... _ _. <br />7'hr, owner of tlic pr mises is._� �� ��� � �� <br />� •� `�-.--.�to: <br />The a�ent is.. ...... �,�..__, �� . . <br />� ..... .. .. <br />.. .......... . <br />This app]icntion, �nithough signed; ;Iia11 not be Uinding upon thc City, until <br />.iccented by the Superintend/r�r�} of the ��.;(r//�� �• ne/pg' rt�m�ent. <br />Signe�..... ^?�..�..'�..•.�C. �� Ly� ' .... 1 P <br />, <br />�-: �_ ... A i it <br />:lccrpLcd.. _. . _...�...—/✓�. . 1!12.: % �'• <br />/ BY ... <br />_ � ....................... <br />. ���SuperintendenL <br />