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- -- ' " - �,vTnio-29-a3-yf <br />R'. D. Form � I 500 J-I- I] C. P. <br />CITV OF EVEi�ETT==Water Department <br />� ApplicatioiA for Water <br />:111 blanks must b GI'cd in or crnsscd �a�t % <br />i' �— � � <br />ii' ,' ...�.'_ <br />IieerelL.__.._'___.__..____':y_._....__.'..__i�.. _ <br />TI1 'I'Hli SUPIiRINTIiNDF.N'1' OI� 7'llli 1'� A'fCR DGPARTMHNT. <br />CI7'Y OR E!'rgg7'T. <br />I herrb>' apply (nr the use nf �rater in accord::�.ce with the rules and "egula� <br />ti�.in, �,r �ri,� w:u�� u�i�,nm:�„e. r„� ��,rn�s�s ���d fixtures �tated belo�r. <br />Durin� tl�c time Ihat any nf the watrr mains map nr taken up by reason o( <br />an}� imnrovements authorized 6y ihe Cit�• ot Gveretl. in or nf any slreet nr nllcy in <br />�.ehich tliry mn• havc becn laid, the City will nn[ be rcquircd to furnish e�ater during <br />Ihe prny;ress o( such imprnvemenis to any cmisumer e�lrnse supplq may thus be nn <br />��IL ��r be linble (ur am� dnmages ir its tailurr so to du. <br />APPlitaiion H<,._%8.3.�----__,s33 <br />�si����: S�—"7- �.���. z — naa — — <br />-— <br />.2 -a.2 7-u -C _.s�«,��� <br />..'� � . � <br />x�._ - - -- - ---- ---- _ <br />-- - -- _ __- -- -- --- --- --- <br />l�hewurklobce�ecutedbp..____'_"_.....____.._'_____________ Plumbrr <br />Stale,vizr u( tnp. <br />��y � �c�� U <br />.� .__T�p to be inserted in the main. <br />.- _-�__.R'atrrcbset <br />.--.. �._Ilath <br />. .. �i_� .tir�inal__ <br />. . ..f.'_� _ �'Inin-(anmYinsi tle <br />. . . _ . _ _ _ SidrmtA :�'SShir <br />_ ___�_Hosebibuulside <br />..__.._.hfcnr-bilrff:i�7�iiilc�HPwpu.es , <br />.. _ _ ___ Hcncirib-inside �. <br />\ ______ ._Hih-forstabtetonlaini�iR :--_..._slall'�____"_ <br />. /� /Number nf persun� in (amil>. <br />- � �"-=---Number n( ruoms in huildin�, <br />�I�III'�1fCI11�tiCti:IfCIUI)CUtiL•(I85A�.r____��__'. `._ _._ ,____. <br />. . � �,I r�_ �"� �� . <br />Pheotenern(IhepremisesiS�'�_`�'�'_'_'_ _. _"__""__-. <br />� Thca�enl it_ __________ _______'__"___.__ .__..._ __..__'__..__._________ <br />'Phis appli��alion, althou�h signed. shnll nut Uc binding upnn thc Ciry', until ac� <br />` cepted hy Thc Juperinlrndrnt,oLU�c \Vn[er.De9arU ent. <br />� � / � <br />Sianed_�7'.T�(�___ ____.____.._.. ___� A�plicant <br />� / � <br />Accrpled - _ I. � li � -Y - -, � 7 <br />�/� -�A..._�.�, }__.__ �-µ�-'--�?..:l2.�!�._. <br />/ , L"� / �.rinlenAeni <br />� , <br />