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4703 ELM ST 2016-01-01 MF Import
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4703 ELM ST 2016-01-01 MF Import
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Last modified
2/12/2017 7:13:32 AM
Creation date
2/12/2017 7:13:25 AM
Metadata
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Template:
Address Document
Street Name
ELM ST
Street Number
4703
Imported From Microfiche
Yes
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.. � � . -.�:-�'1J '(:.J.x-�-�' ��- ' 1 � '1� p!'it �� <br /> � - ♦ - �- <br /> \`;.P.Vomi{-.j6GU—k:.P.Co.—b-26.2! <br /> City of Everett�Wnter Department <br /> API'LICATION FOR W�.TER <br /> � :111 Ulsnl:s mvst bc fiil��d in or crossed out <br /> F.vcrett..................................�. ..........1.........._........1'J?.....`� <br /> TO 17?Ii SUI'EI:INTGNPENT OP TIiP 1PAT1'sR UEPA2:T:�ili\'C: <br /> CITY OP EV�P.ETT: <br /> I hereby nPp!y for the use o: �c:iler in :�caardsnce ��•ith thc rules nnd regu- <br /> lutions of the Nnter Depnrhnent, fnr pw�pases and fi�'m�es �tuted bela�e. <br /> Durin� the timc that any ot the �cater mnins mng Ue taken up by renson <br /> of n.ry imProcemenls autlinrir.eS by the Citp ot li��erctt, in or of mip strcet or <br /> nllep i�i which thcy mny hnvc Uecn lnid, thc City will not be rnquired to furnish <br /> �crter during th^_ progress of such imiirovements to n-y consumer whnse supply <br /> may thus bc cot off, or� IyzlilcSo3uy damuges foy� its failure so lo do. <br /> .:-.:,,.,. <br /> Applica[ion No........_.....'�L........�.�.............i.. � ,1 _ 1 �Q/t-�: <br /> Slod:................ LoL..........�.......J................ Add._.�TU"l.<.a�t� <br /> ............................. <br /> ........................ �� <br /> x�,....... �.'�.o....'-?...._._`�m�...................st«�c 17"' ' <br /> __ ..._ ..... ......_....................... ....................._. ..__.................... _ ..........................._.._..... <br /> The work to be ececuted bY_..___..._... ..._.._........_.........................._......Plumber <br /> 't te sizc of tnp. . <br /> .. ... .Y........Tnp to 6e insenul iu the main. �'y �1110 uPj�'�':;i�.Gl� I :�1'7�: <br /> /........tvn:cr daset �o n�y tar �.l7(3 i�t:.$!;11:1tiG, <br /> ................L'n c h <br /> cf . coror3ct3o�i �r-�+a�= <br /> � �.. .,� .�_ ..�� <br /> ......_._.....Urinal � 1 TIIPt}lcl' c:,;t'C�J �`.0 <br /> _.............Plnin fnucet insidc F»y"�p llltl�l.i{QII Of �r J•JJ pi;Y <br /> _.......St1e n•n�k .�•a�hcr ��:OT1Lh cn thlo raukr�ron cor..:rr. <br /> ................Hose bib oms�ac � ...... tion :�d a(;T'nOd I.+n011 bj/ $I.0 <br /> ...... n <br /> ...Hosc hib for buil:ling purpuses ��ity '7cU':t12 Of 'V:�:`i�t$. <br /> __...........IIose Uib insidc � �� � � �' ;f� <br /> ................Bib for stable containing......._..........stall................... � 'f <br /> _..............NumUcr of persons in Fnmilg <br /> ......d.�..-..:....NumUer of rooms in buildir.g <br /> The premises nrc to be u�ed IIS 8...... _. _. . ._............_..__......_............__. <br /> The o�vner of tt�c premises is....._..._ ..._... _C-..ii:� . <br /> . .. __.__... ._._....._....__..............._. . <br /> ' Phe :iecnt is........................................_........._._........._......_............_............................. <br /> nn�ilic;ition, although signed, ;linll uot be binding upon tUc City, until <br /> �y thc Superintendent of�..t \\nt/er Depnrtme . <br /> , r <br /> _ �iHned...............L��9������..�... %�- . . .... _.... ...1p i nnt <br /> � .� �� � �.. c <br /> q.-T.-...z ...... �Y..�r, ......... . <br /> endent <br />
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