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'LL���-�L! II'LI`-Z'S//I V�'W/��'!�� ��. /��� /J I'/�I,. <br />w.1�.F'orml Ifuu—F..P.Co.--�.pc:d • <br />Cit,y of EEverett-�Water Depai�tment <br />APPT.ICA�'ION FOR ��TATER <br />All tilnnks musl bc filleJ in or cross;d out <br />li ecre t t� ..............................._C/// .�'"%...........................102.'2,/ <br />1'0 TIIS SliPER1N19:ND1'sN'P OF TIII4 l\'ATIiR DEPA.IiT�I�\T: <br />C1TY OP EVEIiI'sTT: <br />I here6y nppl)' fnr the use u[ �cnter in nccnrdance with thc rules nnd regu- <br />Inlians of the Nnta• Der.nrlment, fnr pmpoecs +md ficures sGdcd bclutr. <br />During lhc timc thnt nny of lhe ���atcr mnins mny be tnhen up by rcnson <br />o[ nny imprm�ements nutho:iicd by lLe City of F.rerett, in or o[ miy sLree6 nr <br />ulley in �vhirh they m�}• hn�•c Lcen Inid, the City will not be required tu furnish <br />uader div�ing lhe progreGs af such improc.ntenlc to nny cnnsumer �ch��se supply <br />may tlms bc cut ott, or Obc liable for :�ny dmm�fics Cor ita fnilure so to do. <br />Applicntion No..._._G)....�-'....�.�............_ . . <br />Block.......................�_...�.__.'..... Lot.............'_....__.._............. Add...�......_.e __...................Y.. � <br />A*o.......il lS._....... . _.._.. __.... .. Street � - <br />. .. . ........ .. . ... _ _ ......... . . .... .._.. . .. ...... .... . ......... ... <br />_._ . .... . .. .. <br />7 , � .. ....Plumber <br />The �vm•k to be c�eculed b).__ .. .}.. ��-..c� �.�•..-.......... <br />Cl <br />Stnte size ot tnp. <br />��Z..��.....Tnp to Ue inserted in lhe mnin. <br />....l........._\�'nlcr closet s �_ ��--1�' <br />...�...........Bnth � u I 7 <br />`.:.-- .:..Urinnl � f,r1 `)CJ <br />� � / <br />....._�...—.....Plnin fnucet inside �, �_l' " <br />....—.......5?de �cnik u•asher <br />...—.:...._Aose bib outside <br />_�-.,......._Aose bib for buildin; purpuses <br />.--..-..-lIosc bib insidc <br />....._�...Dib tor stnble contnining.._......_........atnll...._. _��.. <br />.......—...Numbcr of persons in tnmily �� <br />...._�......Numbcr of rooms in building <br />Thc premises nrc to be used ns n._ .. /��- ....... ...... . <br />��) — �-„ . <br />The owner of the Premises is_.......it,S:..t��.:�:.1t,........_....1-J',-�R�'-.��--. <br />Thcngent is .............................................___....__...._..........................._........................ -. <br />This npplicntian, elthou6L eiFned, shnll not be binding upon thc Cily, until <br />.� r� 'ed by the SuPcri�te9d�nt of lhe Nntc�j De(y�y rtm�ene. �, <br />Signed.._.....t.:..:...'.�`.�`.�`...:1.....:.:��.'.'.'.....":'.'......__.....App' nt <br />� ....,a�d..� �.....!.� ........r........108�::::. Ry....�/..�..;��*_._,................_._ .................... <br />�,� � . ' SaperintenJent <br />