Laserfiche WebLink
'.� . <br /> F NT v�1-/o � S F�,�r <br /> 0.'. D. Fo�m 4 1'vF� t-i-I]C P. <br /> CITV OF E1'ERETT�=Water Department <br /> Application forq Water <br /> All blanl:s must be filled in nr ut/rssed��ut . <br /> — —o J� -- - '��� <br /> e,�����. /// �- � <br /> �'O 'PIilS SUPIiRIVI'IiNUi{r'I'",/'� �'i'`I•:``I:RI•?TT'�`{�T37CN�'� <br /> I herel�c apply (or Ihe u=c of�cater m accurdauce wilh lhe rules and reH�Ja� <br /> ���rns af l�he 1Vate�' U:pa�tnt-nt. (or purPu.es :md fizlures stated belne•. <br /> UurinK the ti�re it�at :in)'�r( th��wa�er mains m��y 6r taken Up by (eavin��( <br /> �n'hic'h�the7 m�Y'�I�G�p1',becn�l�i��.`�he Ci y„will'notrbe required lo furnishcH'��er•durinF <br /> th�NruRr.:s.nf such imprnven,enL D�a'�y:or n,.r whnce supplp m.ry thus be rut <br /> ��iL��r i�c liablc fnr�m' dam'ni�•.:(��r its failur�. .i. m Jo. <br /> 1 � �y �Acw�w,i< a.r-- <br /> APpliaalion No..' '_"._ , <br /> 3 __ ..Add. __ <br /> iii����; / , i.��� -- <br /> - <br /> --- <br /> � p(�. �.__. ..__..Strert <br /> Sn.__- <br /> __-__.. ._ ... <br /> ._'__""_ _'__ <br /> ___"'._"___..___ <br /> �----�----�- � Plum6cr <br /> _'_..__'_____-- <br /> 'I�he work lu Le c�ecule �,>'.._�_ <br /> _ _'"_ _ <br /> Slnte s �•o(lap. n <br /> . . .�J�-�7':�p tu be inscrted in the main. ,S}� I _-- <br /> 7J / <br /> � w,c�•�d���� <br /> L ii,�n <br /> u�����i <br /> .... . .� .1'lain (aucet inside <br /> . � �_ tiidr e�alk wa�hcr �.:;i�� /� <br /> " ._Ilo=�'t.ihm�lsi�ic / <br /> .11ose bib for buil'.inF Purpuses . <br /> �� <br /> "__H��sc bib insidc V� <br /> . ... __.talL_ '___" <br /> _'__.'"'13ib(�rstahlrcuntaininti -_.-_.. <br /> _'I�umbcr u(pers•�ns in famil�. <br /> �__Number o(rannc.in builriing <br /> _"_.'"" _ <br /> _._ -. <br /> ".__ <br /> 7'he pren�isec ore t�> >�' u'� <br /> nsa_._ - ..-__ . <br /> . ._.'__'. '__"""_'. <br /> ._.._'_"_' _ . <br /> l'heoc;nerofU�eprem�ses�s ._.__ . .-. <br /> '1'hca�"'ntis __._...._._ _._.' ____.___. .. _ ___..____ __ _________ <br /> 'fhis applicatinn,althou�;h signcd.sl�all not bc binding i�p��n lhc CiIY. unlil ac� <br /> �plcd by Thc SuPFrintcnAent tliy,\1'aic 1`��`�°i'O'^���--7 <br /> C�/ �� .._.APVlicant <br /> Si,ned -.-_-_____'_ . -_. <br /> . 14c. _�a-�y/ .__"'_._ <br /> :1e�rpled.. - - _O'....�'.3 ' _ `/� � ""_Sur �rtm:e.a <br /> �`� <br />