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4619 GLENWOOD AVE 2016-01-01 MF Import
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4619 GLENWOOD AVE 2016-01-01 MF Import
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Last modified
3/7/2017 1:45:07 PM
Creation date
2/11/2017 4:50:01 PM
Metadata
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Template:
Address Document
Street Name
GLENWOOD AVE
Street Number
4619
Imported From Microfiche
Yes
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I <br /> En'�"r 7 -. <br /> 3 1: C . �,�',.�.a�e� -`i= ^?-"j�_' 1.:,,, <br /> l5'.�,Form 1-1600—R,p.Co.--G�2G-21 � <br /> ^� <br /> Llty of Everett--�Water Departinent <br /> APPLICATION FOR WA TER <br /> All birmhs must bc filled in or crosaed out <br /> / <br /> �vcre:t........................... ...._:�r.:�....... . .. � <br /> TO TIIE SUPERINTLNDE,IT pF THG R'ATER DEPAItT\fSNT: 1�� <br /> � CITY OF EV�RETT: <br /> I hereb•� npply for the use o(water in nccordance nilh the rules nr.d regu- <br /> Intions of thc W-�c� DcpnrtmenL, tor purposes nnd fix!w�es stated Gelow. <br /> °f a��YIimp�roecnicnts nuthorized byt�the��Citv ufnEscretf, b�orkof any�strcetsor <br /> xlley in �vl�icl� fliey may hnve been laid, thc City ���ill not bc re�uired to furnisl� <br /> �'�fer durin�; the progress of such impro�•ements to nny cunsumer �vl�ose suPP�S <br /> �����Y iS��s bc cut o[f, or be IinLlc for ;,ny ������bea for its tnilure so to do. <br /> ApP:icntion No......�;�,. ..Z. � <br /> ........................ <br /> Block................................. Lot...�....... <br /> "" Add.. <br /> ........................... <br /> No.... ....... � ..................... <br /> y............... <br /> . �.�........... ..�p_..... .�treet �`i��1.. AlL:vt-` <br /> ............. ....................................... <br /> .. ..........................._ ....................._.... ................... .............. <br /> Thc work to be executed by....................�� <br /> ....... .. .._...r. ......Plumber <br /> St e sizc of tnp. ................�. <br /> i <br /> ��`f•.....Tnp to 6c inserted in the mnin, <br /> �---�Nnter doset C6� / <br /> / <br /> ......-���—Bath / \ . <br /> �__Urinal � ����'Y <br /> .... <br /> ........�.�Plnin fnucet insidc <br /> ................Side tcalk �vnsher <br /> ������v..Hosc bib ouLside <br /> , .., , .�, .- ._.�.�. <br /> ................ osc bib for Luilding purposca � .- � � . ..- . �� .`�� <br /> ���.-Ilosc biL inside ' <br /> �•����•-�..... BiL for stnUlc wntninin '/) 1 <br /> ' 6....................sta11..................../! <br /> .......--Numbcr oi persons in family - / <br /> ����-����...vumUcr of rooms in building / <br /> Thc Premises are to bc used ns u.... . � � ', <br /> , o <br /> 1'he owner of the premises is.........���.,trt—P . .........�.................. <br /> �----v-..'-"..��.Z_ <br /> � . ... _.. . � . <br /> � The agcnt is................................................................ _......_.............................,-i„_. <br /> ............................................ <br /> ' �' ''��'fs npplicntion, althougL signed, shnll rmt be binding upon the Cit , <br /> !� �'a hY lhe Superinte ent of. ie Nnter Depn•tme:tt. Y until <br /> '. Signed.y.......�a,�t,t..... �4ti-`- <br /> . ................. <br /> ..... <br /> � _ .... A 1 <br /> �•ce; ._>......_-�.l'�..........1 . �. .�, _. ... PP icnnt <br /> .... <br /> By.. .... '. . .... . <br /> _ <br /> � .� .. ..................... <br /> � ' "'Superintendent � <br />
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