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�=�i3'ru •s =y- � .3 -G . <br />V.. D. Fcn�: 4 IYA cl-I ] G. P. <br />Cff''I �JP E;'ERETT==Waier Department <br />f�}a�►lic�a�tiog-4. fo� �'�t�r <br />nll binnks must bi• �illed in or crossed oW <br />— c�-�zc, i�i-3_ <br />F.vcrPtc.--------------- . <br />- - - -- <br />TO "1'lIE SUP8RIN7'iiNU13N"I' OF'PHG NATER DGPANThitiKT. <br />CI'1'Y OF G`/IiRGI'7': <br />I hereby apply tor iLe use oC ��'aler in accnrdance with the rules �md reFu��" <br />1iun. u( 1'he Natu Del�•�rUn-nt. Grc purpuses :md tztums stnted bclmv. <br />Uurin�; the time iha[ nny u( the water mains may be t�ken I�reet y��r alfley ❑ <br />:my improvemenls authorized bc tiie City of liverat[, in ��r of nn)' <br />�chich thrY n��Y 1�:��'�' �i°1O 1:����1. mc l.i:�: will nnt bc required tu fumisL walcr during <br />the Pra�ress n[ such iinProvrmen�s to miY eonsumer whnse supply may Ihus be cut <br />o((, ur be liable inr an}' danr'-�;e� [nr i[s C�ilure so ln du. <br />dpplic�i[ion Ka. _ _�' � �-�-�-�'-' _' <br />131uck_.__ . .Lot_..____ Add - _'_ _'_-"'_- <br />__ <br />_ <br />____ .". . . . <br />N�. ''J�6_(,%iat��A-���- -�a.��c.�«� <br />- <br />- - ---- -- --- -- --- <br />---- <br />, __..___'___ Plumber <br />T4c a�ora [o bc esecuted by.__-"""-'_" .._..-. - <br />State si�r �if lnp. <br />0 <br />..�?y_'_'f:ip tn be insertcJ in the maiu. �', l �,S � <br />_ . � ____Nhter doset � <br />_ _ _ �_ ___.Ifath <br />Urinal <br />.____'_ \�. <br />_..I'lain f:u�cet inside . <br />__" �`. <br />. ____'__Side �vall: washcr ..,�... <br />_'_'Hnse6iLnWside �' . <br />. ___--__Ilosr bib (orbi�ildin5 P�rpasrs <br />.. _ .Iln=c hib insiJc <br />________I3ibforstablecontaininR-____ __-. . �nll _ _.___ ,��; <br />_ "Numbrr of persans in f;unily <br />_�- <br />__,�_____Number o( ruums in huilding � <br />'Phc Prcmi�es.^.rc to bc u>eJ a� o -__ _ -.'--_-." ---- _. , . <br />The orvneraf lhe Premize:: is -'�'/�"- -" �_'_""'_-_ <br />ThcaFentis._'___-._ ' �_-'_-'. <br />'fhis :�PPlicatiun.:�lthough si I ���y't'. <br />,�trd bS Che Superinicndent � ch Vu):•ile�� <br />-.__--__'___.'� _.... _ <br />,1rreDted ]'1 Ry'_ ' <br />�: �,�-�� � ` <br />IM�► <br />�, �:,,;:.,. ��: <br />✓ <br />1� <br />