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i=:;-r--�_a.. .-,_ - iwr . E <br /> .-, �T> 6 - �— � y - �% <br /> �< <br /> ��'. 0. Fomi 4 I500 7-I-17 G.P. ' <br /> CITY OF E!�'ERETTQ=Water Department <br /> Application for Water <br /> All blanks must-be�iCed in or crosscJ �mt <br /> r �j � <br /> Fcereil. �� _t��_____J_�.^_.'__ .______.19� <br /> 'PO 'PNE SUPIiRIN'f8Nll1iN'f�0 7'HE NATF.R DEPAR7'MENT, <br /> ( CI'I'1'UP GYERE7'T: � <br /> I hereb)'nPply (or�he us¢o(�,s�er in atmrdancc wi[h Ihc rules and reK��la- <br /> ti�.ru uf The \V:rter Uepartm:nt. (nr pu:pi�ses anJ fixtures slated belon•. <br /> Uuring[Fc lime �h:v any n( thc w�tcr mains may be takcn up bY :easnn u! <br /> anc improvemenls authurizcd 6e ihc Cin�uf ii��crett. in or nf �np stree[ .�r alicr in <br /> which thry maY h:�ve been IaiJ. ihc City will im[hc required to furni�n a•etrr during <br /> the progrc:s n(such improvrments to any consumer v;hc.c suppiy m:n• thus br cul <br /> nit.ur bc li:�bic tur.m�damaqes tor ils (ailnrc so lu do. <br /> Applicnlion Nn._.�.9��'_"" <br /> Rluc{: _"_ ."__ .. Lo[_"'_'_"_ '._ \dd"""' <br /> �. � -.L� -_.. . _ <br /> /� ... ____. ._ <br /> \n..... �U o C/� ..Strcet <br /> _' _.__. _.'__!�O <br /> ' "_""_""_"_""'__ <br /> "_"'_"". _ _"'_"" "" <br /> _" <br /> 'I'hewnrktubee�ecutrdbc ____ .__'_____' -- plumber <br /> . ...__ '._._' .__ c. d <br /> S(.11C V f O(I1�). <br /> � � /� .� <br /> � �__•r,��„ be insertrd in tlie main. <br /> -.'-_.."'\Vaicr rlosr( . <br /> .._._. ._fia.th <br /> ._..._/_ _Urinal <br /> -'_1..--Plain faucet inside <br /> . --_.__"Side�ealk washrr <br /> --...._..'Ilnsr bib outsidc . <br /> . _Hosc bib far huildinR Purpu.cs , � <br /> -____ _ .\; . <br /> -.-____._Hosc bib ineide ?. <br /> -_"__."_Nib tor stable cuntaininH.._.'.__ .__�tall.__��:.__ . <br /> . Num6i�r ot prnuns in family <br /> .. �_Number o(ronms in building <br /> "Phe premiscs am[n bc used ;a a_.._..___._ <br /> ____'_"'_.._._'__.__ .___ _ <br /> _"' <br /> l'he nn•ner o(the premises is ,._.__ <br /> ____. __. __. ..______._'______.'._" <br /> Thc aRen[ is_"'________. .__'___'_.___ <br /> .__- '____.____'_ ____________ <br /> "fhis application.although siAncd, shall not 6c 6ir.�ling upnn �hr Citl'. until ac• <br /> ceptcd by Thc SuperimenJrnt nf thc 1\'nlcr Ueparlm� ; <br /> �,/ . . a � <br /> Si�!ned '_/�(„(�y.� ' � Applicant / <br /> �_� c75' ' / � __' <br /> -Pled.�.�__��91 Ry � <br /> �en^.em L.. <br />