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�_._._,� _- <br /> �'� �-�r : . .. i - i ,� `j - _ , <br /> -� � <br /> �C.U.F�inn J._iSnll--E.P.Co.—�^.c.d <br /> City of E,verett�\�Jater Depnrtmei.t <br /> ��PPLICATit�N F�R �TATE:i�. <br /> :111 bl,mks must Uc filled in or m•ossed out <br /> ���erett�.��7E�S..C�h......Z.Z.....................]!i!..Y <br /> "PO 1'IIE S1IPLRIN'PGrU�NT OP TIIP VVATPR DP;PART.dI�:?;9`: <br /> ciTr or �vsiirTT: <br /> I I�crchy :ipPiy for thc u�', uf �vatcr in iiccnrd:tncc ��•ith �he n�.lc, :mcl rogu- <br /> la�icn:� of t6u R'uter Dupn*;ment, tor purposrc and fisiures �tulcl Lcl,:�c, <br /> llm�ine Lhe time Lnat any of tha u'atcr mains mny 6e tnl;en ui� L�� rc:uon <br /> n[ '.ny ImProcements autliorized by U�c Oity of Prerett, in or of any strcrl ur <br /> �ile}' iu tvhich thcy may have bcen 1aid, the City will not be renuired to furni.i� <br /> �::ter dnrin^ the progress oL �uch improt•oment�s ta imy cansuma� �rhosu supply <br /> n:^.}' Lhus bc cut oit, o(r��be liable for :,ny d:unabes for its fnilure so to do. <br /> Applicalion Nu....lf. . -� Z— • <br /> �......_._.._...,.._��,. <br /> ni����:......._....�..��.�'_....._ Lot.._ ._'.._ :............ naa. <br /> _... <br /> x��. /_�/�. /2 � __._.. _scre�c _ _ _ _ <br /> _._.... <br /> _ _ _ ...._. .. _. _ _.. <br /> �'--> _. _ <br /> Tlie «m•k to be esecuted by _......�/Q c _ , . . _.]'Iumbcr <br /> St dc .izc of tap. � .–�;/,5– (l C r– � <br /> i � —� i <br /> . _.�z:._.Tup to Uc inser.ed in the m�m . �' d, � I <br /> � ,,;�' _.. .t; �. <br /> .._.�...._._\Pater doset ,. <br /> . . . .. ... . . ... •.. <br /> .__�.._.....Bath '� f�,'�.�1ii _ C;`'i) <br /> ....-.__...ur�n�� <br /> �r c;� r.�;�„Gi�:r,�,t�; . <br /> ._.�: Plain faucet iuside � . ..................�..�................._... <br /> /♦ I <br /> _....�._....Side �v;i1k wnshcr � ' <br /> .._..`.......Hosc bib avlside . , <br /> .......--....Hose bib for building purpo,es `�� � <br /> ....._'-.....IIose biL inaide �'� <br /> r � <br /> ......^.......Bib for staUle wntaining........_._.......stalL..............__. ��•. <br /> ........:.......Number uf persons in family <br /> . ... .tiumUer of rooms m buildina <br /> 'I ie Pi'emises arc to Ue used as a.... .. ,��_j� " , <br /> –'�e o�cner of tl�e premises is...� ..��..U��vyl�a��......__. <br /> �,,, agent is................_............__......._.......... <br /> . ........._.......__._...................................... <br /> 'his r� icntion, nithovgh signed, shnl] not bc b�nding upon the City, until <br /> .he Superintendcnt of tlie R�ater Depnrtment. <br /> � ? � ��� -- /y <br /> � Signed�.._.�Yy� , .. ...... .Applicnn{ <br /> _.G��7�!'`.�GQ.C��p�.... .. <br /> .s i � <br /> � .,7.._.� _�.In?� IIp. .�� <br /> / . .` %l/. . ..erintendent... <br /> . . . _ . - - �oY�rar <br />