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�. .a . .. 9- �>. 4. <br />E.v�� �—�o—z�-r2f <br />. R'. 0. Fonn t I500 �-I-17 G. P. <br />,, <br />� CITY OF E1'ERETT==Wat�:r Department <br />�~ Application for VVater <br />All blanks must bc filled in or crossed nut <br />F��crMl....._ .____'_-____L/�_�..___ ._19IZ � <br />'f0 'PHE SUPHRIN'1'GKUIit�'1' O� THIi NA'I'F.R UEPAR'CMEkT. <br />CI'I'Y OP G`JIiREI'1': <br />I L.reby :�pply fur the use u( �eater in accnrJAnce �cith thc rules and regula- <br />Huns n( Th-� 1Vater Deparun ent. (or puri>��se.; and fixtures stated Lelow. <br />Dtvin�; the Iin1C Ih:ll :ulc o( lhe tralcr mains may be taken up by re�son o( <br />:my iinpruv��ments authorized br thc lin� u( livcrctt. in or o( anY street ur alley in <br />ahich thry nay havc becn laid. the CitY ��•iIl nol be requircd tu lurnish water durinl: <br />the prngmss o( sueh impruveiucnts tn any consumer ahusr. �upply may thus Lr cut <br />nf(, or be liablc (or any damaKrs fnr i[s (ailure so to dn. <br />:\pplirntinn No..___r% �os_�-'_.__' <br />Rlnd:._-__'_"". -�..._Lo�L,_�'_�"y"�'_'_,"_'_.AdJ.._.. . '_ <br />Vn.__±'%.�:��pYbb�.�f�-`�0--�..___... ree � <br />— -�(" ""J"' l_a__!•�.1 �.C��_C.�- c.�y.^ `�"�__"_"'_-_ <br />_:.-- � -- --- - --- <br />'Phe ���orktnheesecuteclby .-___._.__'__ . . . -_._'._ ._ ..-.... Plumbcr <br />SIatC SiZe nf tap. <br />1_�I <br />----T,n c� n� ��„��«.•a in Ihe main. <br />� —.w,���d„z�� <br />� _ t�:�ch �-f� <br />---'.--- .Urinal V .�/�--- <br />_._'._-_.Plainfaucelinsidc /`.� <br />. _. _ _ _ _.Sidc e�alk �cashcr <br />. ____._liusebibou�side <br />. ___-. .Hosebih(orbuilJingpw�p���es <br />.___._____}lusc bi6 insidc <br />____"__13ib(orstablccontaininR_______._.<�all__. __.'- <br />___/ -__.Numbcrotpersmisin(amil�. <br />__(�__..Numbcr u( ronms in building <br />'I�hepremiscsaretoLcusedasa_-._.___.____'__._.__._..__...__ .-._'. <br />"l�heo�euerotthepremisesis.____.-.._____..'-____________ _____________. <br />TheaRcnt is .___._.___......._."____'____ _ ._._ ._....._'___ _ . ______._ <br />This npplicntiun, althouRh signed. shali �ml be bindinti upun lhe City, mllil :�o- <br />�:cpted bY The Superimenden� I/l�c� 11hd r D�iartment. <br />�` SiKned'__/!.'=".I-.- . . __ . .... .__. Applii�anl / <br />_ _.__ <br />_ . _._ . . <br />:\eerpi:J.... _- _ . 191 13y .'___ . . . _ ._____.'._._ ( <br />/b _ '12 �� s„..�„�.,,,:.,, <br />�- - <br />