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Tap Nc... #.-P ^7...... <br />t5UKILTEO WATER DISTRICT <br />P P SgNOHOMISH COUNTY, WASHINGTON 8ao <br />1�19 <br />'CATION FOR WATER <br />Mktµ\ All blanks must be filled In or crossed out <br />Mukllteo, Washington ............................................. .......... <br />ip4........ <br />TO THE SUPERINTENDENT OF THE AiUSILTEO WATER DISTRICT: <br />1 hereby ap dy for the use of water in accordance with the rules and regu- <br />lations of the D�ukilten Wnter District. <br />During the time that any of the water mains may be taken up by reason <br />of or)- Improvements nuthorized by the District in or of any street, road or <br />Mice in which they may phave been laid, the District will not be required to <br />fur4dconsumer whose <br />supplyhmay thus tieter gcutroff,,orhe liableess of rfnr any damage forrovements to Itsfailure no to do. <br />> <br />Applicatiom No ................................................. n• � <br />Block .................. Lot ............. ........ ...... <br />. <br />..... Add. ..... ...... <br />a 7 yyrr3S!—sl� ....street ........................... <br />No........ ................. l.............................................................. <br />...S.i? y?......�L.aet..r�!C.......... <br />3 <br />.f <br />State size p(„tpP: .••.•. ........ Inch. <br />R.,,,•,.„,W-M.I........ I.............han been received with this application. <br />.. .....................................-�J <br />The promisee are to be used as a............................................................................ <br />The owner of the premises is ..... ............................ .................. .... .......................... <br />The agent Is. .... . - - <br />This application, although signed, shell net be binding upon tht District <br />until accepted by the Superintendent of the Mehilteo WaterDistrict. <br />Signed...... ... - ................................................................................Owner. <br />By...................................................._................................. Agent. <br />Accepted.............. ....................194........ Ry....................... ............................... ... <br />"'"�"""��� Superhttendent <br />