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, ^ . <br /> ,�.�., Tap No._�'...":..=.'....!_->/ . <br /> .............. <br /> MUI:ILTEO UJATER DISTRIC7 G - �' <br /> SNOHU'AISH COUhTY, VlASHINGTON / <br /> ' I `� J <br /> APPLICATlO�J FOR W;TER <br /> :111 blanks mus; bc fillcd in o: crossed ouc _ <br /> AfuLiltcn, �1'ashington, ..__ __. '� �� �/ <br /> .... .. ......._.. ..... .., 19...._... <br /> TO TPIi SUPBP.II�7'BVDIiS'f OP Ti�IE bfC�SILTHO \I'ATER DISTRICT: <br /> � 7 h�rcbp appl}' (or thc usc of �eatcr in accordancc with thc rules and re4ulations <br /> oi thc T[uLiltco 1Fater Disvict. <br /> Durinr thc timc ihat am� e( thc :�atcr mains map bc takrn up by rcason o( <br /> any impracement autharized hy t6e District in or ot 111)' SICCC(� rmd or allcy in <br /> which thcy may Lave Ucen laid, thc District will not bc rcquired to furnisli water <br /> duriuc t6c procress of xudi imprnvcmcnts to anS consumcr whusc suppl}� ma}• thus <br /> Ue cut uff, or Lc liablc for :m}� damaGc for iu (ailure so to du. <br /> Application ?�o..... ___ ......._......_..._...____.. <br /> IIIocL.__.... .... Loc_.. cj_._._ _ Add��Cl c...�`;'�[�rreirf.. <br /> ....__.__ � _ _..... . . .. ... <br /> _ / l ��! �1 ��/ �,✓is,o �; r7 ' <br /> IVu _._.. • !6.:.7 ' StreM _......__.... ....._....__.....� <br /> ..Jv, � , ` <br /> .� � , <br /> _ ...... .. .. .... _.. <br /> ` _.._......... <br /> .... ........... . <br /> ............. ......... .....F�...%•, F M ........ ..�.. . . .................. <br /> � <br /> Statc sizc of ��.p: ...._._../4'.... incL. �r q p .� ?h�� <br /> �::h�.. 'i �J� � <br /> c"'C ' <br /> $. � :'��-�. ..- . . Ims bccn recci:e2 I s applicatiun. <br /> tavi,itf-_''t, �v�.��� oisr. <br /> _ _. <br /> — ............ Supcnntcndcn:. <br /> Thc prrmi.r� :v� iu bc uscd :s a._`�....�a_!..�..r-•._.�....._..._................_................ <br /> ��' ' /� �..s� <br /> i . <br /> � Ti�e o�rner of ihe premises is...LL.(,-e?.l-v��'.......•�`'............._...r-ee.�.�+.�2^'-1...... <br /> Ti:<� aecnt is._._... .. .. ......__._._. _.__.... ... . ._._.........._...... <br /> .._... .__........ <br /> "I'his applicatiun, dd�ouch si�m.d sliall ��ot bc bindm� upon tiic District until <br /> nrccptcd bp thc Siq�crmtiudent c( tL '�fukihco \1n[cr )utrtrt. <br /> /q�/f ,/J / <br /> Si�nid_. _����1�'E�"/,,..L'�.... c .. /. .��.�/."i!'r��Omncr. <br /> I1}t...._................._..................._.........._............................____.............__.._..........._......_._Agc n:. <br /> Acrcptcd .. .. .. .__.. , 19 __.... By ......_ ..... ..... ._...__.._....... <br /> Suycnntcndcnt. <br /> ��;wii i ��� �/�r'.--z.��v� <br /> , <br /> i '` _ 7� <br />