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�,1-�-d ���-4-�y -n , - -��..`:_..- � : , <br /> R'.U.Pnno 1--I600—E.C.Co.—L-26�21 <br /> City of Everett�Water Depai•tment <br /> � _ ,�.TION FOR WATER <br /> .::: blanks must Lc filled in or crosacd out <br /> liem�et t,...._........_............�//�.............................192� <br /> JPERINTENll13NT OR Tllr'� R'ATi:R llEPtlltTillP•.\T: <br /> . CITY OF CVL•'l:liTT: <br /> I liereby npply fot the use o[�ca�er in aceurd:mce �rith the rulos cnd regu- <br /> latiuns of the \�'aler Dcpnrtment, for � �npo=r.: nnd fixtures stnted belo�c. <br /> lluring lhe limc thnt nny oC thc �.r:der mnins mr.y 6e lnken up Ly renaon <br /> ot nny improvements aulhnrizrd 6y tlic Cit�� o.` I;cerelt, in or of anp nlrcet or <br /> nlley in which ihcy may hnce been Inid, ilie City n•ill not Lc required to furnish <br /> �anter during lLe progress of such improvemenls ta nny consumer u9�ose supply <br /> m:q• lhus 6c cut off, uCr bc liaUle for any damnges for its fnilure so tn do. <br /> Applicntion A�n..._�J_�._{.�.................. 7-Z-'f� <br /> L'lock......._.l4 . _ Lot... -.................._..___. Add.... ... .._... <br /> ..................... <br /> . ._... . .._..._..._._._. <br /> n*o....... .�3.._�_5�..�.G.��,x-..:..n� <br /> / <br /> __ _...._...__._........._...__._........................_............_.............. ..... .. .............._........._...... <br /> 1'he work lo be esecuted L,v......__..__..�--A lc�...—.._........_._......PlumUcr <br /> Statc aize of tnp. a� <br /> 5- _ _ <br /> _ .. ,- <br /> �Y.......Tnp ta be inserted i thc r�win: , , � <br /> ..._�.........�Pnter closet � ' . �� --'' '� �.... <br /> _ �� . . i i� .. <br /> ._.............Bath ' ��-.UV � ��)-. <br /> ......-......Urinal �� .� E',:�. (f ;nT!_H . . <br /> ._..L.....Plnin fnucet insidc . ......... � ......._.._.. ..... .. <br /> ._.....�....Sidc �•nik ��•ashet � ; <br /> ......�........Ilasc bib ouLside <br /> ___. ..._..14osc bib fo: Uuiliinl; Purpos�as <br /> __. <br /> ................ldosc bib insidc <br /> ..............l3ib for stuUle contniuing....._......_.....slall.................... <br /> ........:......Number of persmis in fnmily . <br /> .......,Yr......Kumbcr ot roams in buildir.g �/,/J <br /> The ��remiacs nre te bc used ns a..��-���—�(Cn-.--.�?�� <br /> . .. .... .......... .................. .... � <br /> The owner ot the pre�e�ises i:t...._....__._..... ._.._.__..._........................................... <br /> Thaagent is................................................_....................................._....................... <br /> This npplicntion, nitlrou�h signed, sholi not be bindin� upon the City, untit <br /> ncceP•ed by lhc SuP�rin ctuenl ut the 1V r Dep iment. <br /> ,� ti �_...-�� '-�-�-�. �. <br /> Signed..... ,.�. - ' . <br /> �� , �.:. .., . � .���.,��� licnnt <br /> Acecpted..___........�. � 192...... .Dy..... _.. ! . . ...... . .. .._. <br /> �._._ _......:.i �... .............. <br /> / � �� , Su erinlendent <br /> r' <br />