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( <br /> l <br /> ,_. /V7 !/ "f..�[i -/% '�� <br /> � <br /> � <br /> V.'. D. �_::n 4 I500 d-1-17 G P. <br /> G►TY 0� CVERETT==Water Departanent <br /> Ap}'lacaticra� ��'�r ��te� <br /> All blanks m��s��' ' i led in or�r��ssed nu[ <br /> � . .._.______191�_-_ <br /> F.vcret[..-- -j .._____ .'_ . ____ <br /> 'I'O "PFIE SUP8RIN1'6NDBV'f R TI1E'VVA'f;2 DL•PAR7'MIiN'P, <br /> CJ'fl'OI' E`1L'RBTT: <br /> 1 hereby:�PPIp (��r the u�e af �vatrr in :�ce��rdance a'ith the rules and regula- <br /> timr of�Ch� 1Vr.ter D:Par:nunt, fnr purPnses and Gs[ures st�tc<I bulow. <br /> Dw�ing [he time �ha[ anr ot the water mains moy be taken uP by reason o: <br /> �vhic1h�thry ����Y imve•�be��zl�iJ,�ILe�City`��(ill'not�Le rcqu ied to furnisL�a'a[er�during <br /> th�• proKress u�such intPruventrnta����ts'(ailure so�ta dohose suPply maY lhus be cul <br /> ��if. ur bc lisble for anY��"'�"'Gc�(��( -7 <br /> � �) J� <br /> ApPlicnlion Nu.".�!/-`�'-c1,' '- ' <br /> lilock �� _I.nl__ <br /> � / Add____-'-"_"____'- <br /> .`-T--______ ____ __._,._.-_ <br /> �.2�02 ��� - �^�'`"- .s««•� <br /> �,,._- - — - - - - <br /> - -- - -- <br /> --- — -------- ---------- <br /> - .-. ..--'-------- - -- Plumber <br /> -- -- <br /> 'fhe��•urk tu be executcil b)' _. .. -'--____'_."" �. <br /> s�,�,• ,�u� �n,,. i�jf_'�'��GE' ,. <br /> __���"CaP ro Ue inse.tr.d in the main. i�/ � <br /> '_�__.W ater closM - <br /> .._.______13ath J' �vY ����^;�. <br /> � <br /> .Urinal ^ � �•���. <br /> -__-'_- �'�� 1 �� � T`, <br /> ---'-._.Piainfaucctinsidc �'�,J 7i�Q�,�ll��,�1 <br /> __Sidc �calk ���asher � 'L( ' _ .. � F�'� <br /> 1 <br /> __'___'_,_Hosubiboutsidc � .IIII i . i 1Q ir <br /> _'___'.-_.11ose bih torbuildinS Pur:roses \ �\ �CP"'_ _ �•. :�; <br /> � a..,�'i:" <br /> ________Husc bih insidc .. . .. <br /> —stalL—'-- .. �.'%i,,i.,, <br /> __"'_-'__llib for>tahle containinB.-___._._ �t �. ,,; <br /> � C <br /> -, -�umbrr u(pers�ms in (amilY . . <br /> NumUcr��(ronms in buildinq <br /> "__"__" '__'__'_'.-__' <br /> __... <br /> 'Che premises are to be used �s 1---- �--- <br /> The ow•ner of[hc Premises�s ___'_."-_-_'- <br /> " <br /> ______________________'___._. <br /> Theagcnt is- . _...__-_. ..___.._____"___ .__-______-_.____ <br /> _________ ____ <br /> 'lliis :�pplicatian.:dtlm��gh signrd, shnll nnt be binding��p��❑ thc City, until ac <br /> ceP[cd by 'Che Superin�endenl n( he H'ater DrParunenL / <br /> /� ._."./�__�pplicant <br /> Signed__ "— '- ' ��J� <br /> _ <br /> � ��� ,i ,i 0'_"'_______"'__"__'_" <br /> ���yyy ' ____ '., - cir,.rintenacn <br /> An:epled..' /�- J�- / — <br /> / <br /> i <br />