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n .� -r—ti - . � - - <br />,�.-wnc_d._. �r -�- , '�? f , r_,_ - , , . �. � <br />w. D. F„rn, b-�r�uo-L.CCo.—c �a2n <br />City of Everett�t�Jatei� Depai�tment <br />APP.LTCA�'ION FUR WATER <br />:111 blanks must Uc filled in or crossed ouL ' <br />-- -- <br />r�•�, �u......_.. 5 ._.__..`f.........._............� s�zrl.. <br />ro 1•ur•, sur�aiu`T�vnrv�r or Ttir �v.aTrs ��nniiTUE:.'r: <br />crr� or �vr•.���Ti�: <br />I hereby npp;y for the use of e::rter in nccmv2mice �cith :he rules nnd regu- <br />Intions of the \t'ntcr L'ep:n•tment, for purposes nnd iix:ures ,tated Ucic�s�. <br />Dm�ing lhc titne thnl ��ny of thc ��'%�ter mains m�y be tnLen up Uy tcaeon <br />of nny� �mProcements euthuriecd i�y Hie Citp of Pcerett, in or of tu`�' street nr <br />nllec in �ch�rh thcy mn}• hn�•r Ueen laid, thc City t�•ill not be mquir� � o furnish <br />u•nter du�ing Ihe progress uf such im��roeemen!s to nnp consumer whn,e supplp <br />m:iy thus be cuL uff, or 6�li�bl�fo�my dumiU'es for ils f.iilure so to iio. <br />:lpplicntian A`o ................�'..........._._.:... ' ? ($ y <br />2._ ...�............. Add..... <br />Ulock.........�<? ..............._.,. Lot..�.��.��}�-..-...^ .._. ..... _ . _. ... <br />Nu..._��%.. O_�.........-�.[Y....S.�i..5�-'^�._ .._Strcet <br />. . _.. _.......... _.. ......... . <br />.. .._.. _ .......__..........._........._...._......_ __....._...._._....___. ... _.. <br />.... Th�� work to U� e�ecuted Uy...... .__ _ . ._. . __ .... ........._.__...Plurober <br />St�tc sizc of lnp. , (� , _ �! �' � <br />v � y_�-�� , <br />�.;�r...:..Tnp to Ue inserted in thc mnin. v F � _�� <br />.._..L...._«'uter closet �Iy ��� -/ '- <br />......�.....Bn[h <br />................lirinnl <br />c� <br />..............Plnin t�mcet insidc .- <br />...�-..�Side «�nik �rashcr <br />,_,....r-..—.I�losc bib oul;idc i• <br />! <br />..... .....Hose biU far buiWing purPnses j <br />--�....:Hase biU insidc <br />................I3ib for slablc contnining._..__..........stnll......_....._..... <br />�- <br />_ Number ot persons in fnmil;�� <br />..... ........ <br />.._�......NmnUcr o[ rooms in Uuildir.g • <br />The P�'emises nrc to Ue used ns n.�--�-�-'�'�"�-�-- -"' <br />'1'he o�cner of che premises is ... .. yyLt�'T��.t-��- <br />The ngent is...._....._......... ......................... ... <br />. ............._..._._........__..._. ..... ....._......... . <br />This np�ilir.�tion. nithuugh signed, ahnll nM Ue Uinding upnn the City, until <br />ncee��tcd by the Supori tendent of the \Vater Dep:irlmout. <br />Signed�E�..�..�c�r% rM�i� .. ........... .. . � _......Applicnnt <br />Accepted__�/,1...:�...�.__....1!12.. .. I3y_. .%.� _ .j'/�_ ...................._....... � <br />� �'�- Superintendent <br />