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r_�,,._�.-�,i--_' � 6'NrI�+S�?Y-=.Z%�j <br />��'. D. Fcrn 4 I500 J�i-17 G. P. <br />CITY OF CVERETT==Watcr Department <br />Application for �Vat�r <br />All 6lnnks must be filled in or cros�se(1 ����i <br />A <br />5% 7i` .I9tL.L. <br />livcret6-..___.._ �. "___ ..____.___ <br />'PO THE SUI'GRINTf?7DIiN9' OF'fllli WJ;PIiR �=IiPAR7'�IIiNT. <br />CI1'1' OP EYL'KGTT: <br />I hereby apply Cur �he use nf water in :�ec��rdance with the rules and regula� <br />Ii��:is n( The AVatcr D:porunznt. for purP�scs and fistures stated bclow'. <br />UurinC ds lintc ihat :�n)' ��( thc aaler mains may bc �:�kcn up by rc. son uf <br />an�• imProvementc :u�lhnrixed by thr Ciq• u( lirc�ctt, in nr o( an}' sirert nr alle)' in <br />which they nnv have been IaiJ, the Cit ��•ill not be required to Wrnish a�ater durin� <br />�he Prngress n( such imProvemrnls l�� any consumer a'hu=u supply may thus be cu� <br />n((. or be liable (or any Jam�^��geti tur it< ailure so to dn. <br />Applirn�inn Nn._�`�__/ �—'- <br />___ <br />131nck q_.-.�.�0-' -_ .' _...�-v_'____..._._AdJ-_-.____-___.__. <br />\o.�-`-��-�-- --`-'-__'_" _�-'--'�----...Strect <br />.._..._...._..______ . _'_._____. _ __._.__'__._.__._________._'_.__.______ <br />'I'he�rnrktnbeescculedby-_--__.__'. .-__..-_.'_____________ Plumbrr <br />State 5' e�d tap. e <br />� � ) S ' <br />__.__!!"PaP to bc inserled in the main. �/ �, _, I <br />/y <br />- -_(_--N'atcrdusei <br />_._..�__l3nth <br />.. _. _Urinal <br />� . ___._.Plnin fauml insidc ( <br />_ __Sidc �vnik washcr �� <br />__Horc bib outsidc <br />"_"'___.Hote hib for 6uildinN P��rpascs <br />'+ Hox bib insidc . . <br />.. _ _""_' <br />� : +.�`..'; _.___'.___Bibfnratablerontaining.-..____.'_.stalL__. ____' <br />�� . <br />�'..: e" "_. — Numbcr �t pers�ms in (�milY . <br />._ _ I�_Nwn6rr o( roam� in building <br />ThePremisesaretnbcu�edasa ..............'___"..__"'___""___ "'._. <br />'1'henwncrofthePremisesis..___.--__.._.....___ ____________ ___________. <br />ThcaKent is..___'.__ _..__._...'______.___ . _____ ______________'_____ ___- <br />_, 'Chis aPDlication, althouFh signed, shall unt bo bin i��i the City, until ao <br />� rl fan; cepted by Thc Superinicndent o( Ihe \\ nter U. <br />�. i � � � �_ Applicant <br />Signed _'__" '_ __ G 7"- -__ <br />n� <br />4 / ��f <br />;. � Acccpled. J� �-f� l� fl . - ...- _.. -.-.-. <br />- � - ,i . ' . . men�,.n� <br />