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. � � � " n <br /> K'. D. Fcrm 3 :500 3-1-1]G.P. {�1'�� ' <br /> CtTV OF CVERETT==Water Department '' ^ � <br /> Applica�ian for Water <br /> All blanks must be filled in nr crosscd uut <br /> lirerett. .._ __'.��/_�.��_ _._�______191 l:__ <br /> / _ _ <br /> 'f0 THL•' SUPIiRINTGNllIi'�T O�THIi\V.1TER DEPAR'f\iGNT, <br /> Cfl'Y OT I•:7GRETT: <br /> 1 hereby aPPIY(��r Ihe use of waler in :iccordance wilh !he ndes and reFula� <br /> � �inns of"fhe 1Vater Uepartmant, for purposes and fixt�rcs stated 6e1ow, <br /> Durinr; the [ime tliat any a(the wa[cr mains may 6c aken up by reasun o( <br /> ❑ny improvements nuthorized bc tiu� City of Gverett.in or o( any sVicet or allcy in <br /> �vhich NteY m�aY have been laid,�[he City�cill not be required to (urnish�cater durin4. <br /> th: pro;,•mss a(such improvements tn any cais-umer mhuse suPP�Y may thus be cut <br /> ��I(, ��r b�• liable for any damages for jts faiWre so [o do. <br /> lol ' <br /> APPlicn[iahn No."""�(. p ,,/� (/� <br /> 131ock . G_�-'__ ______LoL_"'_'J-___..____Add�..l�{{,(�j�'p__ '�( <br /> ._-No..__._. . . �__'�_�_�s'�e�____..Strce[ Y � - <br /> . � <br /> "_'-_' ' __""_'____"'_51'_'_'_"_"__""_"_____'___" <br /> � '1'heworktoUcexeculed6p._'__'__'_".____'___'__"__'____ Plumbcr <br /> Slalc sizc o{IBp. `�� <br /> - �__.__Tap [o be inserted in the main. � � <br /> � <br /> _�___�__._{tiatercloset � '� � .i � <br /> --�-_.�,�h �y ;:�`. <br /> —..___ _Urinal <br /> -._.____Plain [aucet insidc ���v{��^�� <br /> . ____,_Side�valk washer �� / i� - `'\ <br /> ____"_Hnsebibuutside �� 7� ' � ,e\:.. <br /> : �� , �., .� <br /> � °, <br /> --________Hosebibfnrhuildinqpurposes -��� � <br /> -.____..__Hoscbibinside ����Z� , �? <br /> ""_"'__'Uib(nrs�ablecon[aining.'_'__"_'st L. _P�._ ' R' ,.� <br /> ________.NumberofpersonsinlamilY ��\ "'�:�• <br /> \ �� <br /> I.I-•---'Numbcr nf rooms m bwlding • C j� _� <br /> /� i <br /> "Phe Premises are to be used as a___"__LL¢.C_�_O�, �,.'_' <br /> _'_. <br /> 'Che u«�nrr of lhe premises is _'_"____'_"__' <br /> -__._._'_.__'_______.___. <br /> The n8ent is .______._.___. ___________"_ .____._ <br /> '___'__"'___"___'_" <br /> 7'his npplication, although signud, shall not b�binding upon the City� until ac- <br /> ccpted 6y Thc Supe:inm�id ri (the Nnter D�t�rtment. <br /> Siqned _��:i.�J��i�-���.______ApPli �in[ <br /> Accepteel-� .����_._1975-1 13v 9 <br /> � <br /> _ `--__�_ _ _____________ <br /> / U _venmct:cm <br />