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1429 BROADWAY 2016-01-01 MF Import
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1429 BROADWAY 2016-01-01 MF Import
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Last modified
1/23/2017 8:23:04 PM
Creation date
1/23/2017 8:22:18 PM
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Address Document
Street Name
BROADWAY
Street Number
1429
Imported From Microfiche
Yes
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.�...,��-�° � <br /> � � . . � ��.-«�R _ ' � <br /> �= N ?-v , <br /> w. o. e��� . �seo a-i-v e.P. u�� Q.u.�-1-. � <br /> ClTY OF EVERETT==1Vater Department <br /> Application for Water � <br /> All blanks must bc fillcd in or crnssed nut � <br /> Gverclt�.__'.__"______._""��[� �"_.___191�___ <br /> TO 1'HL+SUPIiRINTENDCN7'O�THL' WA•PGR pL•'PARTI�IBNT, <br /> ' CI1'1'OF G`/ERE7'T: � <br /> I herebr apply (or tl�e usc o(walcr in accurdvncc with Ihc rules r,uti rcguln- <br /> lims of'Phe lVater Uapar(ment, (nr purposes and liz[w�es sf^ted below, <br /> Uuring thc time that any o( the�ratcr mains mc�b^ taken up I;y reason n( <br /> any imnrovements authorized Ly the City o(Evcrelt,in or of any street or ai!ry in <br /> �chich thcy maV ha��:becn I:iid. the CiIY��'ill nn[bc reGuired to lurnish x�alcr dcring <br /> L'u prrgress at suah improvcmenls tn nny consutner �ehnse supply map thus 6e cu[ <br /> u(f,ur be liable(e�any dam�•gcs (ur its failure su [o do, <br /> ApplicntinnNo.___7�S 8 <br /> "'_____"' <br /> ��i���k ._2_8.�'1t_-- ------��/��---1�_:-_. 1 6------.�aa._--------�--------- <br /> ____No._'_...�-C(iZ.�."'_,¢�"..Slrect <br /> '___""""_'_'_"'_"""_""'__"""".. <br /> 7'6e work to be esecuted by..__'____""__' ' _'___________'_ plcmber <br /> Stalc sim of[ap. <br /> ���__..Tap ta bc inscrted in Um main. o <br /> S � <br /> - __.______.1Vatcr closct �j •� 1 —' <br /> '--'-'---Rath <br /> .__.___ .Urinal <br /> � ---"'___'Plain faucet in=idc <br /> --._______Side waik tvasher <br /> --._.___._Hosc bib uutsidc <br /> _'___"___liosc bib torbuildinR P��rposes <br /> ______._Hnsc bi6 insidc <br /> """"'_I3ib for wtablc containing._________slall_'_.______ <br /> ------___.Numhcr ot penons in tamily <br /> .._..____.Nunilcr o(roams in building <br /> 7'hc prcmiscs arc to bc used ns a______________________ <br /> .""________' '__-' <br /> Yhe mcner o(thc premises is ____.._ <br /> .._"___...._'._._'___"__.'_.__""__".. <br /> 7'hc agent is._"""'_'_"""_"_'."_'" ' <br /> '1'his applicalinn,althouFh signed, shcll not be binding upon lhe City, until:o <br /> mpted by Thc Superintendent of thc W9L�r Dcparlment. <br /> Signed����_t�,-�__ _, <br /> '__-__ "_ APplica� <br /> Acccpted..//.—a�_'_19 -T�i/ B'.'��=`-��r <br /> - / 5 -- ._______'-5ut+rimm�Aem -' <br /> �.�i�� . A�/�. . <br />
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