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�,�:u._ , , - ; <br />�'�--d ��-�r-�s ��i. • <br />\\'. U.l'orm �1 1]ne _E.P.Co.—u :b21 <br />City oi Everett�—�3�Iater Departinent <br />AP1 LI��ATIOI� FO�. ��T�� <br />All bla�iks must oc tillc�i in or crossed out � <br />��/ 8 <br />...��z h.. <br />rverett................ _............. ................ _...................... <br />TO ?'1117 oUP�:2INTI511�rNCITY OR CVC1:liiT;D�YAP.TAi�tiT: <br />I hereUy �iPP!y Lor thc� use ot �antvr in .<cerd.^•nce �t'itlt the rules and regu- <br />IationsDuring tl ettimD that��nny o`- the �e:der nu�in's mny Ue taken p� by'•rcason <br />of nny impcocements autlm:ized by tlic City ot FV:�� ��ot�bc�required�totfurnish <br />nllel' in �rhicL thep may l�aec bcen laid, the City <br />maY itl us �be cot ntt o�r/ be Ilable�fo�l�amy .lmnages�for� its�f•ilure� so'to do u� P�Y <br />� �: <br />Applieution No...�0�-.�_� .............'.... . <br />'• �' % -� .. . Add... _._.. ... <br />.._..___.. <br />1�4_�1!._......._.. Lo��_.r...C..J._...__.. .. ._.. <br />Block................. ....... <br />/`/ — ._......_........._....Strcet <br />No....���/-l..��..-......_...�..�.......__.. <br />_ <br />. ........ �.._._.... <br />_. <br />. _ ....... .. 7 <br />_ <br />� .�t.-G ,/ - . ... . P1umUer <br />'fhe work lo Ue esecuted by- ��� t'/� ������� <br />State size uf tnp. �� �L. � � (� !'3 � �, <br />� <br />...��......TnP to Uc inserte3 in the m;�in. ,,. :_.. . ��, . .' . <br />_..�_.,.,,,�Vatcr closct <br />Ci <br />......C........BacU � _ <br />.....::.........Urinal '� <br />...... �:.....Plain fnucet iusidv - . . <br />.____:.......Side �cnll: «�ashcr <br />__.(..........ITu=c bib oulside <br />._...-..-.:.....Iiuse bib for building Pnrpo.,es <br />.._.—....FIosc UiU insidc <br />......_---.....Bib for stuUle contninin <br />g ................._.slnll.........._........ <br />.......—.,..Numbcr af Persons in fanrly <br />._.,_„7....._A`umUcr of rooms in building U, . <br />...�pr..._ .... --� <br />1'he Prem�ses arc Co be used as n - ��,,� �; . <br />, -t . .�::. .....:.. <br />�r• ,�vner of the prcr.iises �s..,.� / �'�l�•��-� � <br />. ..............._................_........ <br />. ._........_.........__.._ _.. <br />;ent is........_ ......................._..... <br />oplication, nithough signed, sLull not Ue bind'ng uPon tU Ciry, until <br />� t9e SaPcrintcndc of the \Vnter Departmeni. <br />� ..__��� P tcnnt <br />..........!�/l.°%^2:Jt/c-�c "-r � <br />Signed.. �....... � � � / A <br />r <br />,. - .. <br />� �� .e:..1a2r'`.'.. IIy......�. .. •���� �� ���rintendrnt <br />��_..—�.�`.._ ! " � �.� �, <br />i �...j�_ <br />