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-u.._-.C.�,It—a.... � .. �� � '1-1—'�.� I`rw1 <br />n'. c. innn a- �auo—g.rr.a—L-�uza <br />City of Everett—�•W�ter Department <br />' ,- ` T TCATION FO �K WATER <br />p11 61:u',Ics must Lc filled in or crosscd out <br />- �.f1,��r.._r..._..._.......i:�� �.. <br />; l:ccrctt,.......__...� <br />'Cb�T-_f•. SID'�RIN'IENUF.NCITY OP�F.V1:�P.I:TT UEPARTIl1liN'f: <br />I lureLy nl!PIy for LLe usu of �cater in :,rcerdonce �ciih the rules and regu- <br />I¢lions o[ the \�'nter Department, (or pmpo��es 'md fis urc� ctalcd Lelow. <br />During �he Limc thi�t anp of the u'ntcr m::ins mnc be tnken vp U�� rensmi <br />oi any improvements m�lharia.ed by the City of L•'�'crelt, in or ot nny sLmeL or <br />nllcy in trhirh Ihec mn5 1im'c bcen lnid, the Cily will nuL Le reqaired to furnish <br />water during ihe progress of such improcemenla to any cnn,umer ��hose suPP1Y <br />may thva be cut ult, upr e I�nble [or anS dmnnges {or its fnilure so to do. <br />Application No...O..�.3..~/ ..............._..� ' / � � �� <br />Ulocl:... . . .. Lot . .�-� .. _. __.._ Add . .. . _ .. . .. � "��. <br />..St.ee��' � . �.. ._. <br />. .. ... / <::Ll1'-G..._4-KGl.(�1�., rR.. />/ � i - <br />No.!.�%%ICGf2i¢,. ��.�<Y ' n <br />p. / N� o�< <br />�� M/. CC.[/G�?i / {, • ......... <br />. ....... . . � � / .. <br />The � otl lo Uc esecuted U(�p :��ti:L�`' �s� . .. ....-. . - . Plum6er <br />`0 / '. l. : ',11 0�.. . _�i 1 t � <br />Sta�-Ize oC tap. ; - <br />._�.��...Tnp to Uc inscrted in thc mnin. '�.G j"-n`J iOP '%�f. ln:s':,tll::": io7: <br />' .' <br />G, (! L.CLC1'CiG COILILC�uIGI? :.• <br />....:_.........\l'a1C[ Closel -� .3'f C :• <br />I furt};er ;.E �o I`=Y <br />unth 3•00 per :.�onth <br />.... � :,ir,ir�v.r.: o: (. <br />_...........Urinul i i� o- t:�;.e :-^�ered ^onr.ect.:en <br />. . 11�1 �j�l <br />................Plnin fnucet msidc , .,_. :-.["ccr. Ltj:oYl �.}; -.,� 1°.: <br />i..� . . .,.,.�:.� <br />................Side a�nll: n�nsher �, . Otl,-, "_l '." '�,t . . _ ., . <br />........._....]iosc bib oulsidc <br />.___.........Iiosc biU tor Uuilding purposcs <br />....__........ilose hifi insidc <br />................13ib for stnble coutnining...................stnll_..__..._...... <br />.__..........Namb:r of persuns in tmuily <br />... ... ....NmnUcr ot rooms ia Luilding <br />...��� � __. ....._..._.._._.. <br />The P*�miees nrc to be used ns n..._.. ... . .--- <br />The oo'ner af tlie premises is..........._._.._._..._.._.._... <br />__._.____.._..........._....__ .. <br />. . .................. <br />Thc aFent is....._............_........_ ............. <br />.._...._. ......_. _...........__......._.. . <br />Tl�is nPD>icntion, nitlwuqli signed, shnll noL bc binding upon lhc City, ntil <br />nccented Uy the SuperinlendenC o[ ihe Nater lloPjjrlment. <br />SiSned..��.._._(/1.�.....�/V..0 . _ .. ..................Applicnnt (: <br />� _ . .. .. . . ........ / <br />Arecpted_....�.-�.....�'% .T...192...... BY.._..-%'/- Supenntendent � <br />� ............. <br />