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7iU�✓ .-- F �'f-� r II C � �� .• <br />, C,C.IA-r �_. � C r-/ _ 1 r <br />\\". D. kbnu 4�.qGGO-E.P.Co. 5-26-2C <br />Cir�, of Everett--�Watei� Depai�tment <br />APPLICA.��iON FOR �v'�.T� R <br />All 6lsnks must Lc fiilcd in or crossed ou}. <br />�eerett .... ...................�� �... ._.................._..."t92�.: <br />TO TIIE SUI'ERINTTNllliN'P OR THP �l'ATP7: DliPAI.Ti�SliN'Pi <br />CITY OR EVPBETT: <br />1 htreby r.n��ly for the v��e uC �mater in aceord5nce u�ilh tlie rvle, nnd re u- <br />lations cf the P.'atrr Ucpartmnnt, fn: purperes and Lixtures stnled bdoa�, S <br />During Llm t�me that nn3' of [hc wnter mnins may fie tnken up by :easou <br />of nny� improvemdn�s uuthorized by tho Citp of F.cerett, in or of uny strcet or <br />ullcy in wliicL thcy may hace Lcen Inid, the City ���i]I not bc required to furnieti <br />«':der during the progress oi suah inttanv2ments to xny conumer whose suPP�Y <br />m:iS thus bc cut off; or Gbc IiaUlc fCo/r :my damages for i4; fui]yr�c eo to do, <br />APPlicatinn No.......0... .`1...:3...T.... ���l,Z�'1 <br />c �-, - ,. <br />Rlock .............. �...J.!-�.......... Lot.._:2!._..... .... � , <br />'/ G f/ _..__ .. . Addll.l..4i't--.v1..�,..�.:-:?-.. '.:: ,-- ./- <br />No.._..�..T10......_..�/�Y��� .... . ............ .Strcet �I <br />� ... . .. <br />._..........._..........__._...__...._.........._.__._.._.....__..._......._......_.._ ..................___...._...... <br />Thc worL- to be executed by.. . . 1.........._.......PlnmUer <br />, /. _.. O.d...._... ` <br />State size of lnp. . .. . �` � '—'. . /b �Ij ..�1�. C . <br />..�._Y Tnp to be insce[ed En the maia -�_. � -� � <br />� � � � � <br />..............R ::er closet '�.` <br />i, • <br />. <br />......._.......Bnth ;,. `� Or �'l : <br />................Urinal �Y•'� � . � � -�. � . <br />:.. <br />Pinin L�ucet inside � � .� �jrF^ . �� �� <br />.......�..�.....Side walk washcr �. •O '' r, <br />.--..._......iiusc uiL uuisidc .......... <br />____........IIose Lib fer Luil�ice purposes �. <br />................Hose biU insi:e <br />................BiU for rtn4le contnining......._......._..stnll................._. <br />................Nwubcr oC persons in family <br />................NumUer of rootnc in building <br />The premines n':e ti: br, used ns n......__ �, - <br />f��...a....__....._._.__ . <br />. __......._.._.... <br />The owner of the pteciisea s_._........_._._........._........._...__. <br />....._..._.....__...._... <br />..�ent is ............................................. .. <br />. . .._ _.._.....__..._.........__....._ ............._.._.... <br />^��P��cation, ¢Iti:ough signed, shall not be binding upon the City, until <br />- the 5uperintendcnt � tbe N ter Depnrtment. <br />'ignedf.i...... y�. ��L�.�li%% �.Yl1 ..'.......... _ �' ct. <br />. ....._..... >.......Ap i nt <br />i - <br />c'..-.�0............10� By..... � ,�/ ; <br />. _... _ _. Y� .�._....... <br />i. . <br />$uy4r+ntuudent._ � <br />