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/_ �� ' • . _ _.• - _ . , <br />�". D. Form 4 1�00 9-1-17 Q P. <br />C�TY OF C1/ERETT==Water Department <br />Ag'plication for VE7ater <br />:11I blanks must bc filled in or crnssed uut <br />I:vcrctt. .. . -�'i s ." ' ' <br />..____ __... 191.__:_ <br />'I'll 'I'I-Iii SUpIiKIN'PGNUI?\'I' OF 7'Hli R'ATEIt DGPAR7'h11i�9', <br />CI"1'l� UP ti`/EItE"I'T: <br />1 hrrruY : pplY inr tl�e use o( water in accnrdance �cith the niles an,. rrgula- <br />�:��:u u[ The �Sator Daparlmrnt. for purposes [md fixtures stated bclo�r. <br />Uuring tlie time thnt any uf [he water mains msy be C�ken up bc reasnn ,d <br />.iny improremunts �uthurizcJ by [he City u( liverelt. in or o( any sircet ur allec in <br />�vhii.h they ma5' have 6ecn laid. Ihe Cit7 �rill not bc rcquirrd lu furnish water during <br />t���• p����;ress o( such impro��ements t�� ang consumer whose supply m:n� Ihus be cut <br />�"f. �,r be Iinble tur nny damnges (nr it (ailurr so to du. <br />< <br />Applicn[ion No."' __��/ L <br />"'_ _"_' <br />Iilnck.____"��"J__�__Lot� __'_'_AdJ_._'_' <br />__ _-___ <br />. ....._ .__ .._ <br />Yu.__—.� �._� _ � " .'_"_"_""__...Strcr[ <br />" ' ___"'__" _._"_."" <br />'_"'__'__._..____"'_ <br />'"' __' _ <br />'fhe work lo be esecutrel by. _..._._ <br />-�------ — — . !'lumber <br />. . . _ _ _. . _.... <br />S[ate sy.0 nf tap, <br />..-�/7�Tap to be insrrted in the main. <br />. . —'_1Vatcr dosel <br />—. -- __.Iiatb <br />...___ .Urinal <br />----__Plain (auccl inside <br />�---'_Side walk e�ashcr <br />- ..---"HnseLibuutsiric <br />. -. ---__Husc tib (or buildin�; purpnses <br />..---__Hnsc biL i�sidc <br />13'1 ( <br />�l / � � V'_ <br />-_"'_'_ i� i�rstablrcunlamm�;_._.'_'_._�.,.II "__' <br />� --L� _ .Nmnbcr nf persuns in (amilr � <br />. G--_'A'wn6cr o( runms in 6uilding <br />1'hc prcntiscs are to be used as a_ <br />"fhr rnvner��(theprcmise: is __'. ____ _.� <br />Thcaqentis.._"'___' / 1 <br />� /y/� <br />"I'his npplicatinn, altho� 1 s�gned,_� ;iil n I I i,✓b� <br />ri�picd by'Chr Superinten en ��a t�r�, n�..�/� <br />_ _ .____�'�_ <br />Arci-p�cd —7 -_'_"_'�_.191 � _'_' <br />_� - � � -�.= � G <br />� <br />g upo rth CitY, unl�l ac <br />� ���_ _ - �� <br />� � -'_Applican[ <br />JC7 . ' "_"__"_ <br />��:,.�����«.,���� <br />� <br />