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4925 ELM ST 2016-01-01 MF Import
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4925 ELM ST 2016-01-01 MF Import
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Last modified
2/12/2017 7:30:16 AM
Creation date
2/12/2017 7:30:08 AM
Metadata
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Template:
Address Document
Street Name
ELM ST
Street Number
4925
Imported From Microfiche
Yes
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, <br /> �-�V.,.L , - � �, . , �.�. ._ . .. � . . . . . . <br /> �..�� � �_ • ;�� � <br /> �e.o.t'o.m��-i snn._e.r.co.-s:ns� <br /> City of Everett�Watei� Dep�rtment <br /> —.-- <br /> - ��ICATION FOR V�AT�R <br /> AII IlIet1I:5 must Uc filled in or cros=ed out <br /> . �VCI'CLC�..................:/...Z...�................................_..ID� <br /> '�O TIIE SUPGRINTENDGNT Ob' TIIP \VATI;it UEPACTNINT: � <br /> CITY OF GVtiItETT: _ <br /> I hereby npply for Uie use of water in :�ccordanee a•ith the �vles nnd mgn- � <br /> Intions of thc 1Vater Dep:irtment, for purposes :md fistwros stnted Ucic�v. <br /> During qm timc thnt nny of thc �catcr �unins may Ue tnken up by renson � <br /> of nny improcements authoriud by the City aC Iiecrett, in or of nny strccl� or <br /> ullcy in �chich �hey may hnee heen laid, qie City n�ill not be rnquired to furnish <br /> �eater during the prugress ot such improvemenls to anq consumer �vhose eupply <br /> mny tlm= bc cub of[, ofr/be lin`Ul/a for :�ny dnnt;tges for its fnilure so tn do. � A <br /> Applicntion No....,4..�1..7��.... ..��g3 �°u'"� �lt�.�-.�T �i-cu'. <br /> . q/� /� <br /> [31ock.....�.�.-............ i.ot. �.�..�..........._......... Add.. ..K ._._..............__.... <br /> ..�/_ �_� ���v""` . . <br /> . No.... . _. . ._.. .... .........12........._......_....Strcet � <br /> .............._._._....._............_..................................._._._....................... .............................._.... ;. <br /> Thc work to be ezecuted by._._._......... � .Q.G..__..........._. .............._.....Plumber <br /> StASC fi1ZC Of tIIP. / <br /> ..�/.�f�......Tnp to bc inscrted in thc main. � .. <br /> ........�......Natcr doset ' <br /> ......�.......Bath •'�. , . - <br /> ..._..�-......Urinnl .-' � _ <br /> .....�".....Plnin faucet inside „ ' <br /> _........._...Side walk wnsLcr .� �� . <br /> .......�.......FIose bib oulside . <br /> ._._.. ....Ilosc bib for building Purposes <br /> .....—.c:.._Hose Uib inside <br /> ......�..BiL for stnblc c,;�itnining....................stnll.................... �� <br /> ... ......NumUcr of persons in family � <br /> ..... <br /> ...�......\umUer of rooms in building. <br /> The P�'emises nm to Ue used as .. . �..�iM......,..... <br /> '�/ ' / .......... ............ <br /> The owner of thc premises is... .. ...�/�:.1./L-C/��ti._._..._ <br /> Thengent is......................._....._...........____....._..._..................................... <br /> .................. <br /> Tliis nppl:c:dian, nithough si�neJ, ,hnll not bc binding upan thc City, until <br /> accePted by Lhe Superintendc1rt of the Vnter Depnrtment. <br /> /�b n� <br /> Signed....�F....._.�......... ........................... ...... .............................Applicant , <br /> Aceepted.._�....-��...r........1:12�. BY . . _. G�. <br />
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