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� 1 J_ ' , <br /> �--��-1\-�- . "` c:. �-.�,t c.���-�-. 1': � <br /> �yt�.Porm.J -��oo—EP.Co.-S-4G2J ` '�' <br /> City of Everett'—Watei� Department �. �- <br /> AppLTCA TInN FnR uT�.TF.R <br /> � All Ulnnks must bc filled in or crossed out <br /> �..,.�,�«................ . .. ......�1�,.. ..._......_._..._��.�7 <br /> TO THG SUPI3RINTliNlltiN9' OF TI�C R`ATER DPPAI.TilfENT: <br /> CITT OR &Vli12liTT: � <br /> I hereby n�iplg for the use af �cuter in acwrdnnce�vilh thc rules ar.d regu- <br /> lations of thc \�'nter DepnrUnent, for purposca and fistures stnted belo�v. <br /> During lhe time thut nny of the �vater mnins nmy 6e tnken up U�• rnnson <br /> of nny improcements autLoriud by the Citp of i:��crett, in or nf nn}• xtreet or <br /> nllep in which Ihcy may hn�•e Ueen laid, the City n�ill not be rr.luired to furnisli <br /> �vntcr during thc progress of such im7iro•:emencs to nny consntncr wfiosc suPP�Y <br /> mag tims Uc cut utf, on c� linblc fm• :my dam�iges fur its fnilurc =u to do. <br /> Application .�o...._...8.6.6.i.......... — 7 � 3s <br /> . <br /> i ai��x....__..3.1.3._.. ....... Locl...-.2n.... . ..... ... �aa.. ... . . . _ _ _ ��--� <br /> No...�.�...�_./.......�,..v(���`-�-�'-"-���._..............Strcet <br /> I) _ .__... _..............___._. <br /> _____ . . . ........... .. . . _.... _..... <br /> The wo�k to bc esecuted Uy. . . ��_-....... ._....Plumber <br /> .___ .. ' � ,_ � <br /> St� c s;ze of tnp. `l1(f� ��' � � u�' <br /> � ._.��......Tnp to be inser:ed in the main. � �� � <br /> ,� �� <br /> _._,....—R'ntcr closet .(�}� <br /> I� .....Bnth �� 1I� �-Mi <br /> � J <br /> I ...�-..,�Utinnl ��j <br /> �I _�'...Plnin fnucet insidc G� <br /> � ._.............Side �calk �vnshcr <br /> i <br /> ��..Ilosc bib oulside <br /> �'.I�osc biU for building pnrpu;es I <br /> ......�..-...iIose bib inside /+ <br /> ....-.-.:.....Dib for stablc conlnining....................st�l.... .............. � <br /> :�..Numbcr ut persans in fumily � <br /> � <br /> .. _�._..NumUer of rooms in building � <br /> : premises nre to be used ns n... . . __ __. <br /> / , _... <br /> _. . .__...___. .._....._.. <br /> .;. uwncr of tLc premises is.(,�f,Jyt�..,.._._.._ . .. ._. .._.. .. . <br /> �yhc agent is................_..........................._................__........._..._. . . . <br /> ......................_... <br /> vis npplication, nlN�ougL signed, shnll not be binding upon lhe City, until <br /> ted U� Lhc Su er' tendcnt o/f 1thc 1Vnter Dc rtment. <br /> S Signed r..':`.:..:?.'.!c.....C..!i!Z�-P�!S__ _. .. .......... .............Applicnnt <br /> Acce tcd......4...`�L.........._.192... . Bv... a'. <br /> p � /.. ......................... <br /> � " <br /> Superintendent <br />