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�....F.:.... � �.. �r. , .;L'.i�. <br />CITY OF CVl?RETT==i'✓ater Departmeirt <br />�p�laca�tion for �ate� <br />t1�� b�auls mus[ 6e filled in or crnsscd out <br />Hvrrcu� . _' /'3 . __.I'JI ./. _ <br />'___'__._".'_"./o <br />_ �_ <br />7'U "Plll? SUPIiRIN7'HNllBn'1' n� 7'IiG R'A'1'ER DL•'PARTRiGN'I'. <br />CI'1'Y OP Ii''JERG7'T: <br />I Lerebc apply (ur the u:,e �( water in :iccurdance a�ith Ihe rules and re7;ul;r <br />tio:i; ui'phe AVater Uapartmrnt. (or pw�pus-es and fisWresstated belnw. <br />Durinq 1he timc that anp ut the wnicr �nains m:q� be [al<en u�, by rcnsun uf <br />any imnrnvements authurized br the City ri Gverett. in nr o( anp strct[ or nlley in <br />�rhich they m,iy� have becn I:�id. the Citc x�ill no[ 6e requirrd [u furnish watcr duri��p <br />die prnHress nl such improvemenls to nnv cnnswner �rhnse supply ma}' ihus be cut <br />off, or bu liahle for any damages (ur its i:iilure so la du. <br />dppiicnlion Nu."_ fJ'�'� <br />Blnck._'�f �— "�__" <br />___'_.__Lu�___'____.__ ___._Add __ <br />p / �No.----�._U._�_v_.— .�_O_ `� ---._.__..Stree.t . . . . <br />____ _.__..___ . __.'___-. <br />'_'_'_..___"' <br />___'___...._. _ <br />The work �0 6c e�ecuted bY'--'��_O_1.G2.2.Q���. . ��� -- <br />— Plumbur <br />hta�c sizr u( L'�p. <br />��_._Tap tu be inscrtcd in tlic main. <br />-.�.__..__l5'ater closet - <br />'� _-.__Ii:nh / <br />-_. ---- .Urival <br />_-.___._..Plain lauce:inside �'�� �•.:.'-�._..� <br />` _. <br />- Side �calk u•asher . . .��' ', I. t±, . <br />-_____._Ilusebibou[side � ' � �� <br />i; �. <br />____'__._Hose bib fort..�,iinK Purpmo �:,� ' . `__ <br />__.11usc bib insdc i � � <br />� � <br />� f <br />"-__I3il�fnrstablecon�aining__ _.__ .._stal� � <br />� �` <br />_ C____'Numberof peranns m G!mily \>,�: .� - <br />._rJ____'Numbcro(rnomsinbuildiu7; ��'�.���^}.._.. <br />7'he promises are tn 6c u�et1 :is :i ___. ___ _ <br />- _____'___'_'___"__'__'.._ <br />'I�hcownern([heprcmisesis _____. ._ . ... <br />Thc a�;ent is ._'_"'__ ' <br />'fhis :ipplica[inn. although�si �����, sh:/i�p' <br />cepted 6p The Superintendenr , f� W,i � <br />/� / � <br />Signea __._. �,C_' <br />Acct Pled �Y` �±-�f � - � - � 9� <br />. . �'�-�. � i3�/� _�, � <br />_._____'______.___ _.. _. <br />� u�nn the%l,ill'� UlYil :ic� <br />� <br />