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w: .. <br />I�I�ILTEO <br />� � � SN021UAIISH <br />� ;, , <br />Tap No.. �.i.......1 �....... <br />��l%AT�R DISTP.ICT <br />COU'�'TT, R'ASI�IINGTOn ��� <br />,`,t`- '' Z. <br />�°"�������,,n�SI,,,��� f�,F`OR c��cAuTER <br />�Ivkilteu, 11'ashin¢tun . ........................_............................... ]n.1........ <br />TO Tlll�. SliPf:I:I\7'li\I�li\T (IF THIi 3fUI;ILTEO R'ATEh DIS'fRICT: <br />1 herol�y ;ipl�lc Cm� thr us� af �anler in accnrdnnce «•ith the rules nnd regu- <br />lations of th�� \Iukiltco R'alor Uistric;. <br />llm•inF tLc dn:c tha: an�' of thc ��•nter mains mup Ue tal:en up hp rcasen <br />uf :mp improvements uuthorircd bc the Pisvict in or ot �mt• strer:, road nr <br />allec in tvhich tLep mxy h:n�e been taid, the I�ia:ric; �cill not be required tn <br />furnisL �catcr dm�iu�: thc pra�,rrc�s of such improvrments to :my cm�sumer v:hosr <br />supplp m:i}• thns Lr ru: n:f, or hr linblc tr.r :m}• dmn:i�c Lor its failur�. sn tn do. <br />:lpplicntian Nc.... <br />� � <br />P,lock ................. � .... Lot..........L�...............__... Add...... � .._...�� `'� <br />/ ................ � <br />✓ ... _ <br />No. _ ............. _....... <br />.....Strect ........_......... _...... <br />�t� <br />%..0..1..Q 3...�... �. n � 1�.k`<.... : .:�<���� ................. .......... ..... . . _ . <br />-�-- � � � <br />_ .........................................._..........._,ti-�.�"r._......._:..__...... ............ / <br />_,_... _- - <br />z '� '' 1 <br />SLitc size of tiip: .........J/ry. .inch. - <br />� `..l 7 . ... <br />$ .............! �`,.............hx� L en recciced �ci:L this r.pplicatiou. <br />�/ _ � <a <br />....r.,� .................................................._........_ ......... <br />� S�q�crintendent. <br />T6c premises :ve to he used us a ..................... <br />The mrner of thc premises is_ ......................_..... <br />Thc a�ent is........_....... <br />Ti�is applicntion, nithnu4h si4ucd, shall no; be Uinding upon ihe District <br />un;il accepted by the Superi»ic��dent ef the Uttl:il[uo 11':�1c3'District. <br />Si� ned ...... .............._.............._....................................................Amner. <br />B}• ........................................................................................A gciil. <br />:l ccepti�d .................................................... inA........ lly.......................................................... <br />Superiritcudent <br />