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�-,., _ K-';- �z.+/ c.v i-.'� �'-!—.:J = <br />V':. D. Fcn��i 4 ISCO d-;-V C. P. <br />CfTV OF f?VERETT==Water Department <br />�pnl�c�tion for Water <br />All blanks mu�t bc fi leJ in nr cr��ssed u <br />v - /,� <br />Evcre!t. � � -_.19Y:-�v <br />_'_" <br />'I'O THF. SUP6RIN'1'IiKUIi?"1' �;P T H WATI{2 UEPAItTMHN'1'. <br />GI'1' OI� E7ER6TT: <br />1 hereby apylp G��r lhe as ��i �cater in :icenrdana• �vith tlie niles and regula� <br />i,��ns oC The \Vxter llepnrhn mt. (or purPoses and fixture, slaled 6ciow. <br />Uurin� lhe time tha[ any ol lhc n'a[rr mains mnv br [aken up by reasan uf <br />,�ne improvemenls authurized by Lhe Cit7 ��f livcrctt, in nr of any strcet or allc}' in <br />.vhich they nmY h;�vr been Piid. thu Cit�• ���ill nnt bc required tn (urnish wnter durin�; <br />thr pro1:re55 of sucl� improveinenls to :my cnnsumer wh��se supply may ihus be cul <br />nf(. nn c� liable fnr an�nriti��.�/i�lure so tn do. <br />Applica[iun Nn../ �J-'-J--.--' <br />Bluck ___�r� .____ __ ot_______ ___________Add.___. <br />, � � �/,A/ -_..__ __ ... <br />\o.. � �!/ -{�iT %�_r7'._vd�'...5[rcet <br />� :. <br />._.._.. .___. . .______._ _ ....... ........... <br />'���,fiie wurle Iu I>e ^��•���[ed bp _____ <br />._.._.__. "Phmiber <br />Vf:l�l. �LC /��f l:ip. ��J��(/ \/ JU <br />/ // �/ C/ `_/ <br />�S� �'Pap to be incirted in Ihc main. <br />' _ .. _ � --1V:ncr dusel <br />'__'__�-.Balh <br />Orinal <br />. ._ _ __ .. Nlain fnucet intiidc - � <br />_'.__Jidc �calk t��asher / <br />i <br />. _ _ . Jlosc bib uulsiJe - <br />. Hasc hib (or buil:ling pwpuses � <br />___._Ilosc 6ib insidc <br />___ .._13ib(orslahlecuntaininl(...-.- - . vtall . . ... <br />. _.. q -Numbrr uf persnns in famil�. <br />_Cl__-Numhrr u( room� in building <br />'fhepremisesaretu6cusrdas:�... . -'________ ..... .......... .. ... <br />'fh�.�oo•nerof[hcPremisesis ___'_.__..__'__-'_'._' .'--_- ' ' -.-_"'.-'_ <br />'�hcagentis.'__' . _... __'_-._'_'_ "._ _'_--_."_'_ . _'-_-"" <br />TLis appliralinn.:dthuugh sign.J.:,hall nol h•� bindi�ig upnn thc Ci17'� until ar- <br />irpte:l bY'Phc Snpm'in:endent u! thc 1V/:d/er Ucp:�rlinenL � <br />SiFimdl'/��/(h- /��. ���-'�� _.ApDlicanl <br />�, _ �� <br />Acrynrd_../ / ._ - 1iy It}v,. . . ,, � <br /><O / / ,:,i.._ -... <br />