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� � , <br /> Tap No..../1..�... .'�..T.'. - <br /> � `11�IUIiILTP'A \��ATER DISTRICT <br /> . � SNQH03ilSfl COUNTT, 1C.a5HITGTO\ <br /> . , J`��. ,�1 <br /> ��'�PLICAI'IOI�' FOR W�TER <br /> �"'� , All binnks must L�, filled in or crossed out <br /> ' Alvkiltco, NushinFton� ........................................................� 1n4........ <br /> 'PO THIs SUPEILIA`TL•'NDI:A'T Or THE 3fUI.ILTEO �P:1TER DIS7'RICT: <br /> 1 heceh)' nPpl}' fir the use of u•nter in ;icrordance with the rules und regu- <br /> lations of thc Aful:iltco R'at,�r Uistrict. <br /> UuriuF tlic time that a.nv of the ��•ater mains ma}• Le t+�kcn up b}• re:isw� <br /> of anc improcernents :�uthorized Ly the Pistric; in o:- of nnc street, roud or <br /> allrc in which t}�e�• nr.iy h::ve been laid, the I�is.rict �cill nnt Ue requircd to <br /> � furnish �c:�ter durin� the prutirress at sudi improvements to :mc cnnsumer �cLos; <br /> supyly may thus Lr ca: off, on c� IiaLla fm� mR' dnma�;c for its failure sn to do. <br /> ApplicntimtNo.............................................._. <br /> p r� T <br /> Bloch....................[.................. Lot......_�........................... Add....._�.._�.........:�.._r <br /> � � �—� <br /> �,,_ � . % , x�.........���......y'..a'......-................_..................................... ......sc«�s ................... . <br /> ....... <br /> � ........................................1'l�u"c�,�,.,-...........�...............�... <br /> �a.�.,.o_........��...k��-....w�..... z � .%y ...��.-� <br /> , l ;. <br /> ' <br /> Stntc siu\tu�: .._3J�:.../�......inch. .;. <br /> 5........5.(.�.. ._............._.has 6een receiyed��te!th this upplicntion. <br /> , � � <br /> ,.�: <br /> ......�_...--'.......................................................................... <br /> , � Srcperi�rteriJrn;. <br /> 'I'h�� prcmisrc nrr ta L,. used as u............................................................................... <br /> Tho o��•ner of thc premises is............................_...................... ............................... <br /> Tiica�;ent is.................................................................................................................... <br /> This :ipplicn[ion, althoach si�med, shnll nnt iie Linding upon the llistrict <br /> . u.ntil accepteJ Lg the Superinteudent of the \lukiltco �i'aterDistrict. <br /> Si:'n ed..........................................................................................0 nm c r. <br /> B}•.........................................................................................4!!cn t. <br /> :lcccptcd.._................._._.....___...............194........ SSc........._..._.................._......_...._........ <br /> S��perinftvdcnt <br /> TOTAL MATERIALS COST ��•S� <br /> FOR OFFICE USE ONLY: TOl <br /> DAT"e COMPLETED �i • '°�- AD[ <br /> POST TO ACCT NO. _ =''/_•'S� `"/ � : _ TO7 <br /> —F --'--`—_-- --- CU: <br /> � - ---- --- "-='------ <br />