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/7/7 <br />Form Na. 1-1. /(u (/� ,x-/ /p <br />Frerett `} / <br />n.....t......................t.0 1 <br />.•� •A • ......... . <br />• � • TO �-"' SUPP•.IIINTGNDf3NT OF THE GVPRP•.TT WATER COMPANY: <br />� .. 1'/h/'.1/�!• nPpq• for the nse of venter in accordance with the noes and regulations of the Everett \Valet Cmnpnn}•, and request <br />that n [./. .. loch tap he In <br />in th i at tL ply n `t)y to , �• <br />zlj ............. <br />?- ThriplumUet x•Uo will do mY war s........... •/ ' <br />........................................... <br />The owner of the premises is.. ... -. • .. • • • • • """' � "' <br />The agent Is .................... . ........ (//J <br />The tenant Is ................ ... .......-.7�.,:,•t • '....:........ <br />/[ (, ..�............................ .................. 6....... ............ <br />' The water rent should he charged to... • ^ •.. • • • ..... . <br />• Signed .......... APVlicnnQ .. <br />Q a <br />(See Other Side). - """'�✓""�• •"•G' <br />i <br />