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,s ,:�=cs�:. �,�� � � . <br />_�..�.l�..�_k� �__��.. -,�_ �j,,�,. <br />/ N•. a Po.m �—�cao—E.Cco.—c-:s-:a <br />City of Everett�—Water Departinent <br />APPLICATION FQF; WATER <br />All Ll:�nl:s musL Lc filled in or cru:ised out <br />�� liccrett........ .�.....�...I .....................152...... <br />� . _..y�. .... . <br />YO TIIE SUPEI2INTI:NUG\CITT OR EVP il TT;DtiPART\IEN'C: <br />] hcreby npplp for thc u�c nf �raler in arcord.�ncc �vith lhc rulrs nnd irgu- <br />latiais ot thc ��'ntcr llepartment, for pm'pnses :md Listtu'es stnted bclow. <br />Um�ing thc lime thnt any o[ lhc ���aLcr mains mnt� Ue tnken up bY 1'i�4on <br />of any improvements authoriud U�• lhe City of licerclt, in or nf nuy aLrecl ur <br />.i0ey in which thep mnY hnve bcen laid, thc City �rill not be required to furnish <br />�cater during the pro�ress ot such im��rovemenis to nn8 ����`���»cr u'hose supply <br />may tlws bc cut off, o�be liaLle � uu�• daumges for iis A�ilure so lo do. <br />Applicntion No......._.�..�.5 ................ ' <br />� <br />r Lot_v� ..�..._._...... Add..........__..._ ....__..__:.. " <br />Block ...... . . ......./� /% � <br />ho <br />,r�/� D `�_, l�i_:�C..{.�[.�—`�___. ._.Strect <br />......_.._.___.........___......._.....__.........._.........._.__ _.__ ............._.__ ...._...._._...................... <br />The �eark lo be eaccuted by..__....__... ._.. ..._. _.._..__..... . 'lunber <br />7� r� er..rtti� .�^ / �5�. <br />State size of �ap. J , .��, <br />�/ � � , <br />__,�j.�7.._Tap to hc inscrted in thc main. � �-�' 1 (!J�� <br />/ <br />.._�,-....., ��'ntcr doset / <br />._..`..-:.....IInth . <br />...�.......Urinnl <br />_.,/..........Plain fnuceL insidc <br />__G_.....Sidc �cnik �cashcr <br />.__ �.-.....liosc Uib ouLsidc _ <br />....G.........Fiocc Uib for buiWing �iurPosrs <br />..._�-....iiasc Uib insidc • <br />..._G-.... Bib for stnblc contnining......_.........._stall...._ .............. <br />.,._G-.-....Numbcr of persons in fmnilg �--; <br />...�.\umbcr ot rooms in building � u'-�� <br />.,' �/ <br />Thc pramises nrc to be used as n . -�� -- �- ������r _�piy�'" <br />r.c1� ii���-�- '°��' <br />Th^ owner of the Premises is. �. - �- <br />❑gent is....._._......__.._....... ................._..........................__..... <br />. ..............___......._.. <br />i npplicntion, nlUiongh signcd, ahnll nut Ue binding upon Uic City, until <br />,,� , by thc SuP«'�n/tcp/ilcnt nt /the Nnter Depnrtment. <br />Signed..^ .C-,(�' �1��.(�1.�...._ ..............1��plicnnt <br />.� �/ <br />.. ....... ................. ....... ....... <br />:pted...� /. , � . ......1n2...... IIy_ . . � .. : . /'✓�!� ................_........ <br />`�..:..�`....--�� '�' �. uperinlendent <br />