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n.� <br />'_ci�d . � ' _ y.._ j j ' 1 �( _ <br />lC' D. i'nrm 9- - t5u0- F..P.Co.—�.:G2/ .. ' <br />City of Everet.—�Wnter Dep�rtment <br />APpLICATION FOR �WATER <br />eVl Ul�nks mu=_L Uc fillcd in or crosscd out / <br />_ �ib L _ .............�:,��.. <br />P reret t........... _ .. ... ............. _.... . <br />_ .... <br />pp �'1{y; �UI9iRl\'Cli\1�1'.NCITT OP'PV131'C'TT:I�r�t��ItT11ENT: <br />I hcrcL,v :q:p;}' for ihe u�s of �vnlcr in aeccrd:mcc «•ilii lhc rules mid reg�• <br />IationsDw�iog lLe,t me Lhat�meS`�� f ihcy ���tcr nv�ins nv���6r lal:een� up�liy rcason <br />of an}• impru�'ements autho:ized by Ure Ciq� o( Ecorett. i�� nr of any elrcet or <br />nlley in ��'hi�h ihe�� mny �hn�'e Leen In�d, LUc City o'ill not Lc required to fnrnish <br />m�y thns�Le �vt of[, or be�Lable'for ony da» agesUfor its fn ivro so�tosdot����,,. <br />Application Vo .........� .�.� � .. <br />... Add... _ _._. .... <br />����_ Iot __. �.�3_._._._... _.._._- <br />Bbck . _ .. ... /� � � � <br />„ �`L.LS .�t�c-.e. i"�-z..^.._;.... ._..Strect <br />\n. •'J_ . .__.�. <br />..._... _....._... <br />......_.... , ._._. � <br />._ ......._. .... O <br />.. �� � _...._Plumbcr <br />Thc �rorl. to be excculed by...- �- a . <br />. <br />S�atc eizc o[ inP• \ �� -- <br />.TnP tu be inse�ted in the main. o <br />N� <br />� ....... � � �� <br />__.....1...._�v�t�r ao=�c o. <br />.._..../......13atn � . <br />_ _..:r.::::.-.Urinnl <br />._..`....Plnin fhucet insidc <br />._ .. ....Sidc �cnll; �cnshrr <br />_ _.. �.-:..Ilo�c biU ouL=idc <br />.`....._...I'.ose bib for Uuilding Pi�rposrs <br />...__-.�...:. itose bib insidc �Tr� <br />.._:.-....�. .Dib for staLle containinC........._.........stnll.........._._..... �) <br />..._'-/:..-....Num6cr uf Persans in fnmily <br />.....(�-...I�umber of rooms in bmldin �A��� , <br />Tlic premiaes nre to bc used ns rt.�� � �( I <br />TLe own!y, �t thc prer.iises Is � � <br />._..__........_.. ... <br />. ...... ..... � . <br />The ngceC �s.....__..._ ................... <br />_.... <br />._........__. . <br />This aPP'�cntion, n�thaueh >ignod� -hn�� not be UindinG upon the City, until <br />necepted by the Superinlendmit of 11;-e/\�'afer lle nrtment, <br />��/� =L/ ....__ ............._.APPlicnnt <br />" i,�"L?..00�.._.... _. <br />Signe� . <br />....... . ..... . .. . <br />.192... BY.._� ......_.... .. c�cerintendent <br />AccePled_.__..... . _ . .. _ . <br />