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u �� �:, `vy�7�i..� `i- ti� -2'J�rr, <br /> t,,,_� �,�._,y_, �1- ;- . .� " / <br /> \C.1).Form J- �:Son- F..P.t n.-6.4-:f . . <br /> City of Everettr-Wat��r Department <br /> APPLICATION FOR WATEIZ <br /> A11 binnks must Ue filled in or crossed out <br /> s� .Z..'S._.............1 p 2�.. <br /> Eecrett............._._......._._...._../.. ... . <br /> TO TIII� FU!9sRINTP•.NDF.�CIT] OP I VIIiGTT��I'sPARTIiI's\T: <br /> 1 liereby aPD;B for lhe u�e nf«•:�tcr in aeaordance «•i[h the rules �md regu- <br /> lations of LLc �Yatcr DepnrMim�t, for pmpu=es and fislur<s etated bc�o«'• <br /> Uurinq ���c time thnt any nf tlm �catcr mnins m�U' �c takcn up bY rcason <br /> o( any impruecmenln auUiorized 6p 6he City o[ Eceret[, in or of +my strecL or <br /> uR:-r in «�luch they ivay hace Ucen L•�id. tl�c City �vill nut bc required tn furnisli <br /> �cnt .: durinq tl�e p�•�Fress of such im,rorements to m�p cnn=umer ��'hose suppl�• <br /> mm' thua Uc cat nft, or 6c liablc fgr nny dau�n6cs [or its fnihire so to do. <br /> S b"� Se - 7/S! <br /> A��plicntion tio... _ . ......... .... `j� �� � n (� <br /> . ... Add. ..`^.'.�`�y+�L��`-. <br /> Ulork......_ . _...... . I.ot... ._. ..._...._... . V <br /> \n.. �rr".3. ��... .__.. ._.._. . .._._. .Street' <br /> ..__.... . . <br /> .. ..... .. . ... <br /> . .. ....._._ . . . <br /> ........._. ...._...... <br /> _. ._. _.. __ . ��_� . <br /> 9'he �cork to Ue eaeculed Uy . . . .. � <br /> �„_ . _._... . . ..Plumbcr <br /> Stn eiZc of taP. , <br /> � ppp <br /> Tnp lo Uc inscrtcd in thc mnin. � •�// �! �� <br /> .._...`f.... � _- <br /> --.,R'nter closet <br /> ................Rnth . � <br /> ....._......_Urinnl ' _..�� ����:..u;s �(' I <br /> `—__ � '.,I'f' n ' . . . <br /> ............_..Plain fauc^_t insidc , � � . .� <br /> —:,..-„_�3ide �vnik �cnshcr r. � : iY[I'-. . <br /> �-. ,..�.�....�.�]4o�e bib oulsiue � � <br /> . _ ... .� ,_ �\ <br /> � .._. ._ .I{usc Uib for Suilding purpaces ' <br /> .�___.�..-.11osc bib insidc <br /> ._.__"_7:Bib for st:�61c cantnining...................stall...._......__._. <br /> _�.... KumUcr ot persons in tamily <br /> ..�....Numbcr of rcums in building � � � � . Q � �.�-• � <br /> Thc premises nrc to Uc used as n �i ;=_"��'—����- —'-I] ����""J <br /> Thc ow•ner ti[ thc premi;es is `��� � ��-`�'�'"����"�— ` <br /> •Thc agcnt is............ .... ..._. . . . <br /> ....... ........ <br /> T�us applicntinn, nllhough si{;ned, almll nct Ue bi!iding upon the Cily, until � <br /> :iczeP�ed by the Superintcy�nl of lhe \Vater Depnrh'.icnt. <br /> Si�ed...�L� �i}�"'"'"��`�"":..5..__._..._ . ......._..._ApPlicant <br /> _. ........ .. ._..... <br /> i�... <br /> Aecc tcd . �J..192. BY� ,.-.... .. .......... <br /> � ._....... <br /> p _.._.__......... - . .i .. .. _;uPerintendent <br /> <' <br />