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: -� -, � i— 9-.ze r�,, <br />W. D. Fo�m 4 IE00 l-���7C.F. <br />CITV OF E1'ERETT==Water Departmen�t <br />1�pp�.icatio rn�for,sW ter <br />Gverett. " �- _._ ___-.___.191�L� . <br />. �1 IiN'P 01' " IIH R'AT. iiR U iPARTTd1:NT. <br />'fU'I'lIL'SUPI'sRINTCi U <br />�S OI� G`16RE7'T: <br />I herebY app1Y (�r the use of ��•�ler in accnrdance ��'ith the rules and regula- <br />tion: �,f "1'he �Vater DePlrtm,n[, for Purposes and fixtures stated bcluw. <br />D�.�ring :he time �hat any uf the watcr mains may he taken up bY rcason of <br />❑n7' in'�provemenL•�. audiorized bc the Cin• �d L•'vcretl. in nr nt an)' s�reet ��r alley in <br />which Uiey may have heen I;�id. Ihe CitS' ��'ill not Ue requimd to furnish watcr durin{; <br />d�e Progmss af such imProvemeNs to any consumer H�hnse supply may Ihus be cut <br />n(f, or bc liable for �mp dam,iges (�� its failure so tn do. <br />ApplicntiunNn.__�/_`��_'_"_-' / .. / <br />/ . <br />.? � ��.11-/ . c�t, �� <br />I31nck _---- -----' -----.Lot__d-- -^ 3 L AdJ_ ._..._. ._ <br />,__ `___ <br />No.,7�. -D_�---�,—���"/;��v""'___'..__.__Strcet . .. <br />+ � . <br />'_ ' --- `—�7-(� .�-f'— -- -- <br />--- _ <br />(' �"_— —`.�/ -- -- - -- .. <br />t-.-G/TL� _ ___. ...-_ I'lumbcr <br />"1'he work to be executed b}�._. _.' ______'_,�``r Z/_ -.. <br />Stute�ir of t:ip. �. <br />__�__ �__ Pap to be inserled in the main. �f, <br />-- --- ..� ,,l' �-� <br />-___!___Waterdnsrt , / �.� � <br />___.�....11a[h ...-- --.,,. <br />�E : . <br />- --- _ -. .Urinal <br />. _ _ _ _ _ _ _ . _ Plain Gmcet insiJc <br />. ______Side walk washer <br />- ,__.__._Hose bib outside <br />._____.__.Ilose Uib for building purposes <br />_ _____ _. _Husc bib insidc <br />_ __.' __'_liib for stable contammR_ _-. _-...-sta <br />� <br />. __.. ____Nwnber of persuns in family <br />__ � _'_Nwnber nf ronms in building <br />The pcemises arc tn be used as a _ .. _ _ _ _ _ . _ . _ _ ... _ _ . . _ _ _' _ _ _ `_,. - _ _ <br />� :S � �._.�.._._ ,,. - <br />�����'��',.��I! !���� ��,. <br />The ownerof thePremisesis ____._. ___________________________ <br />ThcaKentis ___...__.__.__.'______'_' <br />...___ _..__ _"___..__."____' , <br />Tl�is application. altimuFh signcd. sUall nut be binding upon thc City, until aa ��� <br />,:cptcd by Thc SuperiNendent ��( Uic 1Vnter DeP�runci�. _ � <br />%� <br />� {'r _ <br />, , �",y�_-- C -, ' 21_v_Itil���_Applicant <br />- <br />�'` i 13y �i - � �� <br />.___ '_"'_____"' ____ <br />Sup ' i <br />Y�^. ` <br />