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4712 BLACK FOREST LN 2016-01-01 MF Import
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4712 BLACK FOREST LN 2016-01-01 MF Import
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Last modified
1/30/2017 7:01:07 AM
Creation date
1/30/2017 7:00:28 AM
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Address Document
Street Name
BLACK FOREST LN
Street Number
4712
Imported From Microfiche
Yes
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/, /�� �. <br /> w.o.co�m a � <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> � All blanks must be filled in or crossed out <br /> Everett�._..... _. ..4:i: � ..�........... ......__.._...19%.�� <br /> TO THE SUPERINTENDENT OF THE WATER DEPARTMF.NT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance with the rules and regu- <br /> lations of the Water Department, for purposes and fixtures stated below. <br /> During the time that any oF the water mains may be taken up by reason <br /> of any improvements authorized by the City of Everett, in or of any street or <br /> alley in which they may have been laid, the City will not be required to furnish <br /> water during the progress of such improvements to any consumer whuse sup- <br /> ply may thus be cut off, or be liable for any damages for its failure so to do. <br /> A licationNo.. �t-t��' <br /> PP .1:._�._...... �....._.._._ . <br /> Block _....__ _.... _ Add... <br /> Lot .._. <br /> ..__............._..__ <br /> No �:��i� ._..%3�'¢. � �� /��.-:x�.. 8treet <br /> .........._................__..._........._..............._......_.._._....._......._...__....._........._____........_..._. <br /> The work to be executed bY-.....-..-----...._...._..._..._.......__... .____.._._..Plumber <br /> St'a/te size of tap. <br /> ,/��Cl....Tap to be inserted in the main. <br /> -.-----__..Water closet <br /> ......_._._..Bath � <br /> ._Urinal ��� <br /> .........._ <br /> Y ' � � �ti <br /> W . . ( <br /> ..-.......___Plain faucet inside D . n/ „� / ip <br /> q v` ,a r� <br /> .--_.......__Side walk washer ` �p 1�b � <br /> -__........._Aose bib outside �.�,,�r��y�� ��1�YI � �. ,4 <br /> .._..___....Hose bib for building pur ok F+'-, ✓ °`� / � <br /> P cY�., S nI <br /> ...__._.__Hose bib ins:de �pkT -�' � <br /> � __._.........Bib for stable containing_...._..._._.._staltPo^1...�..._..._. <br /> _____....Number of persons in family <br /> . ..._..___....Nu.nber of rooms in buildink <br /> The premises are to be used as a......._____. ..__ .... . <br /> _..._. ..._. ._... <br /> The uwner of tha premises is_._ ._...._.. ......_.. <br /> ._....... __.. .... <br /> TSeagent is._.._....__.. _.......... ____...... _...._.._. _. <br /> � /� a . ._....._....__..._. <br /> This application, although si ned, shal] not be binding upon the City, until <br /> Si ned` n ndent of t e W t r D rtment. . <br /> acce e <br /> . P Y g uPer� � '� � ��t� �l�:�PPlicant <br /> _ .____.:�� . ...._ _ ._...._.. <br /> A cnP.ed..... .._.__.._._ .__.19..._.. By....._ <br /> .._........___..___...I <br /> � Superintendent. <br /> cy . <br />
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