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�c -:y 8._%S`<..<,-j��, <br />lV. U. Form 4-1600--E.P.Co. ! 96-:4 <br />�—,-�J�-�_c� Q . ? - ")<S �''"n' <br />X <br />City of Everett--•'�iater I) �;���rtm�nt <br />A:�F':�:�����TIOr�( ���.�g. Wt.�TE� <br />AlI blanl;a must l�e filled in or c:or.ard ,r!i: <br />-- ' <br />O _ � <br />Pverett ..............................L..,{..."' ...102�. <br />� ..........................._ <br />PO TllL SUP�P.INTLNllENT OF TI3E �Pd'LI'slt DEl'.�IIT?fEnT: <br />CITY OR �VERI:TT: <br />7 hm�eby apPly for the uae ot water in c:^c �rd.nce �cith tne rules and regu- <br />lutions of thc Watcr Department, for purposes und tixtures stnted beloo•. <br />During the time that nny of tlic w�tcr mains mny Le taken up L}• reason <br />oP uny improrements autliorized 67 lhe City oL Faerett, in or of nny ntreet or <br />alley in which they may have bcen ]nid, the Ciry ��•ill not be require:3 to furnish <br />�vr.te: during � 6c progress of such iuiprocemente to any consamer «•hnse suppiy <br />may thus be c �t ofL, or bc liabie for .u�y dumages im• its iailure so to do. <br />F.pplicntion No...._.......�.t�..�.���....... <br />Blocic........................i.:...�......... Lot..............._�:...__........ .. Add......._........_ .__.__.._._. <br />No.......... _. ..ro�''i��....... _. �.�-f:.�...�..�. .. _.—....�..�..�.....-�.�.Street <br />.._........__._ __ ..................._..............._..........._....._..............................__...._........._.............. <br />The work to be e�ecuted bY ...............-._..._._��__.._..........__.....PlumUcr <br />S�t�ate sizc oF tap. <br />.;1.�.�......._Tnp to be inscrted in the mnin. � �� • <br />_.....�.......\Vater deset h C) <br />� BnNi ' '' / "J <br />................ I� <br />-......—...—Urinnl 7 <br />.......�.-.=..Plain fnucet insidc <br />.........._...:Side �cnll: u�ashcr • <br />.......�.Iiose biU ouLside <br />..�..—Flase Uib for 6uilding pnrpuses <br />_ ..—..—FIose bib insido �� � <br />,.__.......EiU for stnLle contnining......_...........stall ................... � <br />................T'umbec of persons in fnmily <br />...._ J.....NmnLer of rooms in buildingh � � , • <br />The premises arc to be used as n....�Lw.�--C��!� <br />C3�'�2.� . .. ............ <br />Tlie uwner of tl�e premises ?s............�-.�.,L. .. ��..,�^_ <br />_.... <br />TF.c agent is .............................................. <br />_ . _ ................. _.... _.............. _....................... _. <br />Thi= npplic:rtion, althou�h signed, ;hall not be binding upon the City, until <br />accepted by tLe SuPerintendeut of l/he� �Vnter Depa ment. <br />�Signed.....:�o "✓1C2......U...-�(.,:.... .(�/.O,;�y!,(%-��`/ / <br />. :�j' � . �.._. � '/L'"^'rY.�l1Y''A �h�lictnt <br />Acceptel.... .' ...:..... ��...:-.. 1;18.� Dy.....L_-. <br />