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'f-Cy{iGq' J�/d�J/ Y� �_._C-�/ l- I/- 3/ -�� <br />, � <br />\\'. U. Porm /—I600—F..ItCu—G-:G.RI ` • ^ . <br />City of Everettr—Water Dep�rtment <br />APPLICATION FOI� WATER <br />911 blauks nms: be filled in or cro�ssed out <br />1.... � � ...193�... � <br />]P.vc rett ........................................ . .. ................ _.. <br />PO TII14 SUPtiRINTLND'�hCLTY" OP l\'li 21•:TT;DEPARTnIENT: <br />1 6ereby apP1Y tor the use o£ �cater in ntt'ord�mre �eilh thc rules nnd 7e6�- <br />lutinns o[ tUc �Vnter llei.:irlment, for purposes �nd fi�!nres stnicd 6clow. <br />lluring thc lime Umt nny o[ the �vnler mnins mny Le taken up b)' rcason <br />oC nny imP�'o��cments aulhm•iacd Uy Lhe City oF Ecerett, in or nf miY +trce6 ur <br />iJley i� �vhich Ihcy may ha�'e Uecn laid, llic City will noL bc required to furnish <br />ma} ll�u.s��be cu�t atf, oreLe linUle�for�sny dmnn8es�fur�its�firilnrerso�tosdou��t�ly <br />Applicntion No......_-_�.�.�..3....._.._ (�t'� <br />`,„ v.._.__.... Add._ ..__ ._. ._. <br />Blnck............_ ..............._......... I.ot../..7..........._..�1.:�...�... .._.. _ .. <br />N o. _._.y". (o. �....`".�......... �. �' 0-=4:c 4r�.'..1'� _ S t rc e t <br />1 <br />� . . � � .. L t � . � .. <br />. ..... � .:............. .........................._.........._........ <br />._. __._...._._.____._.._ ... <br />.......__.__.__ ...... ..:... . <br />Thc work to be execuled by......___.... . . .. . _ _._ . __ _ .._Plumbrr <br />,q tl�ia upplicution i uGrou <br />Sztal eize of tnP• t0 j1�y fOT th0 lnat•n_117t�C:; <br />./�.��,_Tnp to Uc inscrtcu in the mnin. Of' 0. I4039T'Od OOririO¢Z10❑ und <br />,..�............��'nter c�os�t 1 furthor nLroo to pay a <br />unch r.�inimum uf %3.00 � or ��ontti <br />_....u��nnl on tl�is moterod ommoction <br />ua a�reod uron by tho City <br />._.Plniu LmceL inside � � qq�} . <br />.�_......�..._Sidc tvalk �cnshcr ����%�'T. Qf ..YOPOt'�• <br />/s.j�. n (�c J <br />.....IIosc bib oulside ! • %J � I D � ��_'• <br />_ �,J <br />;. . <br />_._..... <br />.....13nse Lib Cor building Purposc�r�' qr � 1 �/ .. <br />�av F�<RET Q,?7 <br />_ . ....._._.I:ose bib insidc -.....,..... % <br />.........._....Bih for stuLle cm�tainin .stnll............ w�..FR !ir; .. <br />g ................. <br />................NumUer of Pcrsons in fnmily <br />................NumLcr nt romus in building / �� <br />The Premises urc to Le used ns n.��-h-- -�''`"�.��...�..n.� � <br />The owncr ot thc Premises is �. e-�=-n- ������1—�..�--Q��a• �-�`-� <br />Thcngent is ..................._..............__..............._ _........_..._...._....._.............................. <br />This npplicntion, nllhon�U signed, nhall not 6e bindir.g upon the Cily, until <br />accrptrl hy lhe Superintendcnt uf U�e �1'ater Depnrtme�it. <br />Signcd............ �:d::�! .:'�...._'�.r��t�{�,�.��..^..5..._._.A 1'cnnt / <br />- -.:ptr 1_c.�r_—��...-::.....'..I.^�! BY......_S��G�.Y!��%._/........��l�� . J/ . <br />/ <br />Supvrinlen �� <br />v <br />