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. �a .. � . E ir7 D '7-i�. , <br /> Cv. D. Fo�m� I500 3-I-:]Q F. , '• <br /> CITY OF �vERETT==Water Department <br /> Application for Water <br /> Ail Lianks must bc filled in nr crossed out � <br /> Ecerctl.-...'_______________"7/� _'__"_.._19] �-D_ . <br /> 'I'O THN.SUI'IiRINT6NDIiN7'OP THf NA7'IiR DEPARTMF.N7', <br /> CI7'S OP Ii78N..-fT: <br /> 1 hereln�apply for the use o(watcr in aceurdance �rith thc rule�and rrgula- <br /> tinns o(The �V Ver D:partm�nt, (nr purpnscs nnd fistwrs stated belmc. <br /> DurinR the time that :my n(the wa�er mains mar 6c taken up by rea�nn o( <br /> any intprmemen�s authorized br the City u(A�•c�clt.in or of any strcet ar allep in <br /> which they m�y have been laid, ihe City w�ili nnt bc required to fmnish walcr during <br /> �he proQress of sach improvemenh in�ny cnnsumer a�hnse s����t}� �,�,>�u,�s 6e cut <br /> ofL ar bc liablc tor nny Aam��Gcs (nr its L�ilurc�o to do. <br /> Applicnlion Nn.'_7'�' Q_�_-_ <br /> Block _7_�'J..�_"_'_' rt____'.�.'�'--____Add.___ ...._._"._-_ <br /> No.-----. _L.z. _t �..�0.�'—�--c�---� _---..SVicet <br /> a <br /> -- - — -- _ ------ -- <br /> 'Phe wrork lo bc rxeculed bp_. _��/..__/��=-cQ_.n,u-�-�-'___-�� Pit�mber <br /> Sta�e sizr of tap. � <br /> �/�__Tap to Ue inserted in lbe main. <br /> ___.__.___15'atcrcloect ' ,� o'�'� �_ <br /> ""'___13ath �F� �9���' �+ <br /> _.__.__ _Urinal � � � �:1\ � <br /> .. ._'__._:Plain :aucet insidc � <br /> --____.___Side�colk �cashcr <br /> ___-_"_Hnsc bio ou�side <br /> .._____.-_{losc 6ib!or building purpuses <br /> ---_.____Husc bi6 insiAc <br /> _____._'_I3ibforslab�ecunlaining.______ .__`tall..._ ____ <br /> _"_.___'Numbcr ot prrsuns in family <br /> .__�._.__Number e(rooms in buildin�; <br /> Theptemisrsaretubeusedasa_._.___-_ ._..______. ...______ ____ ______ <br /> Thcownern(thepremisesis ____.______. _ _ <br /> ..._...._.__. --. <br /> '1'hcaKentis '_""'_""" _'_"" <br /> 'Phis application. althnugh signrd,sl;all uot bc 6indinq upon thc CitY. �mtil ao <br /> ccpted by The S�inerimcndcnt u(th��'nte epartmenl. <br /> � � -��. <br /> SiFuc��__ll��(vY�'.�l"�_'_""Applic;�n t <br /> � ..•pteu_.. ��" � _ .197�.; 13��/"'_" / <br /> , -_.. _ ._. _..___-.-.-.- / <br /> . � '�.^n...: �:.,� — <br /> , , i�, <br />