Laserfiche WebLink
�- �-i T �, ,. � . <br /> \4. D. Fcrm 4 ISDO 0-I-17 G.P. <br /> CI i Y OF EaERETT==V!'ater Depa�tment <br /> �pplica�tRon for Water <br /> p11 blar�ks mus[ c fillcd in�r crosscd��ut <br /> - �f� yZ _- - --19�- <br /> r•.,�«u. ---- <br /> - --- <br /> TO 'PHL' SUPfiRIN7'3NDI:N" ',Y.���,,i•"�I`GAL•"pT PARTh13iN'f. <br /> 1 herebY�PPIY (°r the use of��'�tczcs and (nIu�es�t1at d�bclowy�n�l re6ul:r <br /> �:,,��;n( The `9ater Dsp�irUn�n[.far purp sVicec nr .Iley in <br /> During tlie time Ih�[ :u�y ��i lhe«'.�ter mains may be tak.n ��p bY rensan � <br /> unp impmvement,auth��rized b>' the City nf lvercu.in or a( anY "'a`, thus he cut <br /> �r:iich theY �»`�Y have been laid, thc City��'ill not�c rcquired to fumish w�ter dminF <br /> o1L or�hc linble tur'anY'da noges for its failur�so[n J>1����c supplY <br /> :lpplicn[ion No.__----<-% �z..-:"� `�' /l • • <br /> V Add.�� -'- <br /> ��__ Lot Y _ _ - <br /> __ . <br /> lilock _____-__ _____ __ <br /> _____. <br /> �O � ____'._'__'..Strcet <br /> � ___' <br /> Xo._ __. ._ ..__ _____'. <br /> "__ <br /> ' """__'___"_. . <br /> _""_""___'__"___"_'_""_""_"'__'_'_'""_ <br /> -��.�fhe woik to be execuled bv__.__-._�_______ <br /> _ <br /> .._._.-_.___-- P um er <br /> SV�tc r.�zc �f tap. � � � . <br /> .`���Tap [o br inscrled in[he n���n. � / <br /> �J� ` <br /> /__watcr dusec - <br /> ._._�____Batli �� . <br /> __. -.-_ .Urinal ; I `,' : �,� � . <br /> ; . ',�/'i . +, �. : �`�: <br /> __._.___Plainfaur,ctinsidc � ���� 1;i ��;.'.. � <br /> __.Side walk ���asLer . � �� .) ., ��.� i� . <br /> . ___ , . � ` .� ' . � <br /> -_________Hose bib u utsidc � <br /> � <br /> '__Hose hib-:or building p���Puscs ; ,1'_ " <br /> ___'_ ; <br /> ___._____.Hasc bib i��isiJ� �'�,-� <br /> : �. ;.'. <br /> . . ._-__stall_.__�"•u-[.-.:_, <br /> .____.___l3ib(arstablecontanvng__. __ .. _..._. <br /> _'_Num�er nf persnns in family. <br /> G__Numbcr o(raoms in building <br /> _ <br /> ___'___"_'___' <br /> ""'__"'_'_'_' _'_"' <br /> 'Phe pcem'ses- nre to be use< as a--- <br /> 'fhc ����'ner��f the Premises is __--�------- <br /> ._.._____. .'_____..'___________. <br /> '1'Lca6tntis __"'_'__'__. ___'_'"__"___" ' -.'_"__"--"_"'--"____'_'__ <br /> •������ ���p�ication, :dthuuqh signcd, shall not Ue bindinq upon the City, until ac <br /> -� by The Superintendcn�f the Wnter De}��nent. <br /> U <br /> _ <br /> _"________ApPlicant <br /> igned ___/-" .. <br /> __'._ <br /> � . �- iv yK 13y_ ' '_"" - _ � <br /> -•��a_ �-- j—``---�f/ ---s�.�;�;i�i��::-�,� <br /> r <br />