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P: _ IL 1-'��rn: J—:3QU-.li.CCu.—G.:G-2J <br />City of Everett�—W2ter Dep�rtment <br />�s��LT_�y�TION FOR �3J1��'E�. <br />:AII Llauks muat be filled in or crossed out <br />• _ ,.,, 7 <br />r��o,�cc ............. � ... ............��................. i.�_, _ <br />7'O 1'1�.7�; SUPL:I.IS�TCNDEN'P OP TIIG R'ATI?R DEPAItT➢I�N'C: <br />C1TY' OF PVEIt�TT; <br />I P,ereby npply for the use of �vutier in accordance with the rcl^s ar.d r��g.�- <br />latimis of the �Vater Deparlmmit, for pw�poses and fix:ures stated U�lo�e. <br />Durin� lhc time that m:y of the ���ater m¢ins mny he taken up by renson <br />ur ;,,i;.� i��.p���eemm�ts authoria.ed 6y the City oC Pccrett, in or oL miy aLreeC or <br />::lle}� in v:hich �hey may have been la�d, the City will not bc rr;nired to furni�h <br />�:�aDs luring lhe progcess of such int;.rovements to anp cnnwu���r v;ln�::c �r,'�Piy <br />nv.y thus Le cut off, o b/p,, l�i7nble fur :iny dnmages for i[s i:�'vlw�c �n L� d'i. <br />-�DPlication No.....�IYL'..�./."....._........ —' ,7 � p U <br />i3lodc . .._ Lot(�l-7...-./(� ..... . Add.. .. . . . .. <br />\o......�-�.7��- ����F�n�Street <br />i . .. <br />. ,_; � _._....._._ ........................ <br />..__ . ... . ... . .. . .. <br />.. . The wm�k to be executed U•._ ___.. .. � ._..,.P nnLer <br />5 /S� �41:�. �. <br />Fta/t9 size of tap. � � ,`j �-� <br />..�/-..`_'...Tap to bc in�v��f^d in Uic ni:�in. <br />_ .../ ......AA'ater clo.,et <br />....._1......Bath <br />........-.::.:.Uri nal <br />__._l.-::...Plaiu f:mcet iuridc <br />.......:�_�.....Side teall: �easher <br />! /-- <br />.___/......Hosc biU outsidc "; � <br />._...._:.-...._IIose biL for buildin� purposes <br />.. ._...._... fiase bib inside <br />_......_......Bib For stnUle contnining...._............_stnll..._. .........._. <br />...._._:_...NumUer of persons in fan,ily <br />. - :L�..NumUer of romns in building <br />premises arc to ue used as n.�.. ..... .__�.��%�. � <br />/ _ . ...... _.... _.. _ ...................... <br />���vner of tlie prer.iises is....lil.,�.._....._..L.,.i,LL..:..C_�........_.._......_.__. <br />,��,nt is ...................................._................................_......................_...................... <br />; Pl�iicaiion, nithaugh signc•d, ,hall not be binding upon the City, until <br />. L�� ihe Superintendcnt of the Watcr Ucpartment. <br />f� / ,%7 <br />:1.r�,p:cd.__,-e? e���_.._.1D2 .. BY...�......� �_.��..-.�....__�crintendentnl <br />i <br />