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1223 BROADWAY 2016-01-01 MF Import
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1223 BROADWAY 2016-01-01 MF Import
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Last modified
1/23/2017 7:24:44 PM
Creation date
1/23/2017 7:24:10 PM
Metadata
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Template:
Address Document
Street Name
BROADWAY
Street Number
1223
Imported From Microfiche
Yes
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, <br /> ,�,.,�,,-�ti_2�_��, <br /> . � �._� �),-�,,-, r�»,��. <br /> w.o.eo��o�-�;,00-&r.co.-szs.s� � , <br /> City of Everett�Wdter Depai�tment <br /> APPLICATION FOR WATER <br /> All Slnnks must Lc filicd in or crosscd out <br /> �verett,........../��....................................................192 S. <br /> TO TIiE SUPERINTLNDT3NT OR TIiE \PATGR DEPARTh[ENT: <br /> CiTY OF EVLR�TT: ' <br /> I hereby npp]y for the use uf�caler in accordance with the rules and regu- <br /> Intions of thc Nuter Deparlment, for purposes nnd fis'ures stnted fielow. <br /> During the time tlmt any o[ the wnter mnins mny bc taken up by rcason <br /> of nny im`voeements nuthorized by the City of E�•crett, in or of nny atrcet or <br /> ulley in w�hich thcy may ha�•e Ueen Inid, lhe Cily will not be required to furnish <br /> �vuter during the progress of xuch imprnvements to uny consumer whose suPP�Y <br /> may thus 6e rut oft, or be linble for any damnges Tor its failure so to do. <br /> Applicntion No.....��.(J � <br /> . ....................... <br /> Block....=...._:.....::._................. I.at...�o.`1...:.(..-�..._............ Add.........__......_....._. <br /> ............ <br /> xo......./..aZ..c1..3.......�.l�/.t/...1�...............3trcet <br /> ........................... <br /> . ..............._. . . ..../,....... ... <br /> /...................... <br /> Thc worY, to 5e executeJ by........ - . ,�`...._.....Plumher <br /> Stntc size of tnr. ��"��/ �J�,?Z i . - � <br /> ��',��y...Tap to bc inscrted in N�m�{�� P�-�'--. - � � <br /> .../..........��'ntcr closet ��' <br /> ................Bath � .� � 1 <br /> ................Urinnl '!� � . '�.,- . . . <br /> . -.�...........Plnin fnucet inside <br /> ................Side �t•alk tensher <br /> %-� <br /> -��............Ifose Uib ou4sidc �-- _ � <br /> i <br /> ................Hose bib for building Purposer .� <br /> ................Hose bib inside - � <br /> ................Bib for ste6le conlaining....................stall.................... <br /> ..._...........Number uf persons in fnmily <br /> .-.�........._Number of rooms in buildi ^ <br /> TLe premises are to be used ea n. rp�.../,l.r{/, -( <br /> i <br /> The owner of the Fremisea is......._...................... � .. ... . . ..........��~ <br /> .�f.�....................................... <br /> The egent is................... �/ <br /> ................................................................... <br /> . . .............................. <br /> Thix npplication, although siqned shall not be binding upon the Cit9, until <br /> accepled by the Superintendent of the VVnter Depnrtment. <br /> Signed..�[.�y� .V.....�,_ � <br /> / 1 . . . +�J�L�:t�J'A'!'f�''+-... .A plicnnt <br /> .... <br /> Accepted�-r.?��_..........._.192...... Dy..-� . . � <br /> /-`'C- '�S r� . .c•a � ' ................ <br /> endent <br />�''�` :.i=. � i <br />
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