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� <br />�.�� •�. F��,�, ; � ;�a >>_ � � �. e. o <br />CffY OF E1'ERETT==Watei• �epartment <br />����zlncatidr� for �a/'ter <br />:lll bl:mks must be filled in nr crnssed aut /� <br />/ . <br />s�.Z /i 'y,�"( <br />L'ccrett. __. ";' � �/�________197%e!_. <br />._�/'"__' '_;_'_.' <br />'PU 7'11I: SUPGRIVTHND4:ti"C OP'CH13�Q�ATER DFPAk7'�11iNT. <br />CI7'1' Oh /L•'RETT: <br />I hereby apply fur tlie iue of water in accordance with lhc rules and reR��la <br />lions o('Phe 1Vnter D,p:u[ntn[. [nr purpnses :md listures s[ated Lelow. <br />Uuring the tinte tlal any nf Lhe w.�ter mains may br t:iken up 6y reasun ��f <br />anp imnrnvrmcnts authnri. ed b>�. tiic Citc ut F_vcrett. in ar oi any strcet ur alley in <br />�.vSich lhey nr�9 have 6cen laid. [hc Cily will not br required �o (urnish water during <br />tln• prni'ress of wch impmventents to anp cansumer �rhuse supplr may �nus be cul <br />,dt. ur be liable (nr anl' �:�rmeqes (ur its Liiiurr sn to dn. <br />Applitatian Nu.._ /G o � <br />Rluck ____'��_�_'_10j'__u_�__.-__ '_-_AJd.. .. . ._. . <br />\n.___ ���d�-_-_.�O`�_'47`�1/1..._.-___.__.Street <br />/ <br />"fl�r �onr4 tn hc rzraited hc . . . __'___' ' _ . . __ .. _. ..__ Flumbcr <br />Sbile sy�e o( tap. <br />�/ � ��- <br />._L.�J_"CaP l0 6c i�.edcd in thc main. �j / nJ - <br />. _"f _.1\'atcr do=��l <br />____�'_Ralh � <br />_. Urinal <br />__'__'Plain (aucut insidc <br />_'_'__'Sidc n:�lk ��cashcr <br />. "_'"._Ilusc hib ouiside <br />i <br />____"}luse 6ih (or building pwpn>i�s � <br />_.__..._Ifosc bib insiAc ' , <br />. "'"__'Bib(ursL'�bleeontaining__. __.....tall_.._ _._ �. ' <br />..' _'NumLrr of persuns in (amily / <br />___���'_Numhcrof roum• in building <br />'fhe premises are In 6e used as a' -_ _"___' ' •__'__"'.'_ <br />/p_' / Q ___ -___-. <br />"Phv o�cner n[ Ihe prer.tises is '_l'T.-Q./1_R-�.. _. . 2�L�7--C/1L_ <br />"1'hc ageN. is .."""'_""' <br />_""_'___"'_'___"""""""" _"_"'____ <br />"fhis aPPlicntinn, although signrd,9hall not h� � binding upnn [he City.. until ao <br />�.;ed by The Superiniendent o( the Nnter Department. <br />$iened "_"SG��%2�—�_]:?-�LAf2-nii�U Applic,nit <br />Ac<cpted.N.-�''—..191 Rc_ --- ._ .. <br />� .� _ .. s�.n -r�rirn�r�.� <br />