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���� i�� �;,:_.; _ ,: . <br />_���._,_..� ��l-�,i �" ��,,, <br />\7. U. Fc•ci 1 � 16�i�—.I:II['o.—G-.G.2/ <br />City of Everett--�Wster Department <br />APPLICATION FOR WATER <br />.11l bl:mks mus[ bc fillcd in or croseed out <br />r•.����<,tt .............. __. <br />�1../..3......_.... ...._. ....��� <br />1'0 TIII SUPIiRI\TtiKP,I7NCITY OG' liVE, I TT;��PPAitTD1EN'C: <br />I Le:�eLy ^.pp:1' fm• the use of w'ater in a�'rcrdsnc� �ciUi Lhe rul��q and regu- <br />laLions� i�� lhc�lime that�� �} of�lhe��s��tcr ma in n� y�be tnken up�Ly renaon <br />ut nnc imPi•u�'eme7ls uu;harixed bp tl�c ('ity nf 13cerclt, in or of nny strceL or <br />nlleY in which �hey m:ap hnee Ucen la�d. the City will not bc required to [urn�sl� <br />�rnter dm�in,; the P'�L•ress of .=uch imP��ccemcu:� tn nny co:isnm.'r •.�'hose suPPly <br />inr:� thus b�. eut uff, or(�U'c linhl/e nfor .:��}' dan'��6rs tor it; fuilurc �n lo do. <br />Appliclt�on �'o._._d Q-'?-�`��.. ..�.) <br />Ulock ....... � d ............... Add.. . . .. . ..... .. <br />�Ji.._.. 1 �oc..._,, <br />q Sa 7.-_.-/��%��'�`^' _._._....._Strcet <br />\ n...0' <br />. ...._..__....__...._._ __...___..... _._.__.... _.... . . . . <br />_. .... . . _ _ _...... <br />... . __..Plunil�cr <br />TLr �cork lo be executed hy___ _ . .. _ .. � � <br />Stntc sizc of tnp. <br />��,.._TnP to Ue inscr� ed in the ma�n. <br />_..�.__._. Nntcr closet <br />..�._........ISath <br />...X........Urinnl <br />..2..._.....Plnin f:mc��l in�idc <br />.. X..._-Sidc n•alk �ca,b.er <br />__/........liose Uib outside � � /e� �`!I� /� �_; <br />_X.......Ilose bib tor building purposc{ f ' �i //, � <br />� <br />,__,,,�..... ilosc LiU insidc , <br />.... <br />Bib for stnLlc cont:�ining ...................stali....._....__..... <br />._. __..._Kumber nf persuns in f. mily <br />. ...........Num6er of roams in 6uilding �/J � � <br />Thc premi=_es are to Uc used ns a 0 l.��/�1(�%���`'�-� � 7�-;�--���- <br />The o�vncr oC thc Prcr.iiscs is..... ��'� /�l7- -/��� �?y��� �7 ~ <br />Thc ogent is....... _ . ............_ ....._.._.. _ . .__.... <br />......_ ._..._ t <br />'. nPPlication, nitlioi Rh sitincd hnll not bc binding uPon thc City, until <br />accepLed U� tlm Supcimtc�u'ei uC th� A�n!eT n�1>°rtment <br />Eigned X ( �..�!.v� � . . .. .._ pLcnnt ;. <br />Ac•eptvd. ...�...-.1.�:��.__- BY._. ' - ���enntendent � <br />"__7,�� <br />