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�„�..�,« !� ; �-`� -�_ �� r�:. . 4„-�..1.�,-�-,� i �- i s %� r'o a-,-� <br />. . . <br />tS. D. i�orm a—li,oB—r.i'.co.--s-zc-xa <br />City of Everett�Wnter Depai�tment <br />API�LICATION FOR �jATE��. <br />All Ul:mks must be tilled in or crossed out <br />Gverett ..:...................................... / �..1...�.. �............192 `�. <br />TO THL'' SUPERIN'fLNllPNP OF TIIE VP.ATii2 UEPi�RT\fE�i'I': <br />CITl OP LVEP,PTT: <br />I IicreLy nnply for the u.�e of waler in acccrd:mce with Qm tvlca :md regu- <br />lations of the Nntcr Deparlment, for pm�poscs �md fis�nrrs stuted brlcw. <br />Pw•ing tLc timc thnt anp of t.hc �vatcr mnins may bc L•iken up Ly rca=_on <br />of nny i�uPruvements uutliorixeu by Q�e Cil�� of liccrett, in or of uny atrcet or <br />nllcy iu which they may ha�'e Ucen laid, LUe City will not Le required to furnish <br />�enter dw•ing lhe progress ot such improvemcnls W any concumer whuse s�iPP�Y <br />m:�y thus be cut nff, or 6 linble for :my Jmimges for its fnilure so to do. <br />�Sp �U��,'� , <br />Applicntion No............_........D....L�......... . - <br />`' . Add. � <br />Block ...............�...b....��.........._ LoC...�.�...:�5.. ................_..__..__....... <br />........... ... <br />No...._ ......_. Cfo2-..`�..-� )'%R�. . _Street <br />i � <br />__... .......__ ......_ ......................._.._........_...._........_..............._....._ .........__........................ <br />Thc �vork lo he ecewted by..._...._ _....._ _ .............._. ___....._.............PlumUcr <br />Fl te size of tnp. r <br />i <br />�,�/:.�......TnP to be �nsrrted in the main. :_ I j�--� <br />...../..........R'nter cluset //� <br />....1..........Gnth <br />........_....:.Urinnl . ... ., _ <br />_L'.......Plain fnucet insidc ,� (,!J � <br />. '......Sidc «'�II: �enshcr . �' <br />�....._......Hosc bib oul=ida <br />+-r�.,....Hose Lib for bvilding pnrposev <br />-__...........:I�Iosc biL insidc �� , \ <br />_____.13ib for slnblc contninin�......._.._......st L......I........._. <br />._.�numbcr ot persons in family ` <br />...,�.......NmnUer oE rooms in buildiug � <br />S"•ic premise�� an; to be used ns /n �......... . .............. ............ ...... ... <br />. . . ....... <br />Thc owucr of thc premises is.�Ys(„LL��..... d-t•lt.L- `�.....-. <br />".c agent is..._.._ ................................................._..................................._.............�..... <br />npPlication, nithough signed, shnll noC Ue binding upon Uic City, until <br />.c the Superintendent ot thc V�nter Depnrtment. <br />/ i <br />SiCned....�� c�l�: �...�%�.......�T.:.�� ................................._Applicant <br />,. _ ,o. <br />.,(�.....—f...J.�......-.1J2...� BY._lo::�. .;F ..............��/`�ent... <br />� /� /!� <br />