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`�t�0 �� �-l-zs t}y . �.� �-�� ��—� r h-r��, <br />\1'. D. borm G.. ISUn—F..P.Co.-6:G.21 • • <br />��ry of E�erett�--�Water Depai�tment <br />�CATI�O� FOR ��AiER <br />AII I]IROIiy must Uc filled in or crussed out <br />� / <br />L,•�� �cc ...................../..�,��_%..........................._...i�s._3. <br />TO TIIS SUPLRINTPNDPNT OP Tii� R':1'PrFt DI'sPAI:TIIGN'C: <br />CITT OR �VI.1�L:TT: <br />I hcreby npply fm• tltc use uC tentcr in aa•m�dnucc �vith tlic rulrs nnd regu- <br />intimts of ihe lVnter Departtnmit, for purPoses :rid [ixtm•es statcd brlow. <br />During thc lime thnt nny u[ the �cater mi�ins mny be luken up bp rensun <br />of nny improvements euthorized Ly tLc Cily of I'sccrMt, in or o[ nuy �treet or <br />nI1e5• in �vhich 'hcy mny hn�r been laid, tLe City will not be requircd to furnish <br />�enter duriug lhe pragress of sUch intpravemrnts lo nny consumor whuse supply <br />m:n' lhus bc cut aif, or,��c li�nL/lc f�,r any dmm�ses for its fnilure so lo do. <br />npptication No..._.�,.�..,l.....�........... <br />iilack......... ...,. Lgt.; ... .... ... . . . Add. _.___..... .___..... <br />"� � �� .°-�� -� Strcet <br />No. :'�J I. ... �,.�e_ .. . .. ... <br />i• <br />'..�.�..:�..__....1........�.G�' ..� '. .J......_�\ ...................._....__...... <br />.l � V �' <br />� . _....._....__......_.\..'..... ...._. <br />_. TLc �vork to b: c�ceuted UY..._.._....... .._.��.`�.�` L <br />. _ .......... _.__Plumber <br />�'� Q� <br />StnteJrizc of tnP. �J � � � <br />�7..T._T��p to be inscrted lu lhe mnin. /CU, p,:5 � 3/ <br />..._�::....�Pntcr closet <br />. r r....�......I3nt1� <br />..............Urinal � /� <br />..._� Plnin fnucct inside � <br />....._�...Side a•nll: washcr <br />..._�........Ilosc bib outsidc . <br />....-�.-...—Ho=.e bib for building Purpo=es <br />._....�:...-.FIo=_e UiU insidc <br />..............-Bib for stable conli�ining....................slall................._. <br />....—...:.:�..A'umber ot persons in fnmily <br />,,,.�3Z....NumLer of rooms in building <br />The premises are to 6e used as n..... .�. � ....1 � <br />. _ ..................... <br />The u�enrr of the re.' s is....__.._;�.......... _�_ ..� ._ ... :�`.-�...... <br />The agent is......�."7�.-....�/e.e-,�x-er_.-ft-:�<.-�L ............................... <br />This npplication, nithough-signed, ::hall noC bc Linding upon tl�c City, until <br />nccepted by the Superint�enQ t/o�' the Water Depnrtment. � <br />Si ned... -.��1/%'�/� <br />g � � ��.�.....��.,,p�j�.0� .....................................Applicnnt / <br />✓� / <br />Acce ted._. �...........192_.... fiy__....,.-.... � <br />p ....................... . ..................................................... � <br />, Superintendent <br />