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1710 LOMBARD AVE 2016-01-01 MF Import
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1710 LOMBARD AVE 2016-01-01 MF Import
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Last modified
2/17/2017 4:35:40 PM
Creation date
2/17/2017 4:35:34 PM
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Address Document
Street Name
LOMBARD AVE
Street Number
1710
Imported From Microfiche
Yes
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_ � �-=v 9f „ . 4�<.-�c! .>t.�- _ , . <br /> N.D.l�m�r A-16Va—E.P.Co.—�6-4G-24 . ' <br /> City of Everett�Water Department <br /> APPLICI�T�ON FOR WATER <br /> All Ulanlcs must 6e filled in or crosscd out <br /> � <br /> Everrott�.............................7...._�.................................19� . <br /> TO 1'ui, .".IIP.^.�.RINT�NllENT OI' TH� R"A'L'GP. DEPAP.TIf�\T: <br /> CITY OI�' EVEIiCTT: . <br /> I hereUy xpp;y for the use of �cater in accard::nee�cith the rules and ri�gc- <br /> Intions of the C�ater Denartment, ic� pw�Pose� and &x".ures stated belom. <br /> DurinF the Cme tnnt any of the wnter mains may Ue tnlcen ,p by rcason <br /> of any impro•.ements ::ud�m�ized by thc City af li��adt, in o: of any strcet or <br /> allcy ir. n�hich lhey may hn��e Ueen laid, the City will mt bc required tc furnisli <br /> �vater dm�ing the P�'�S�'ess of such improcements to any cmisemer whose suPP�Y <br /> mcy thus be cuC oti, or bpe linUle/for •.:ny da,aages for its f..ilure so to do, <br /> Application No...._......!...�.�O.l...........-..��0 � <br /> Block............�..��...U....... ..... Lot....r.2.7..�:.<�...�.......... Add.__........ <br /> ._._..._. __....... _... <br /> No........�7.L U_....�p-.:r_ti�....�..........Street <br /> ..._._.._.._............................................_.......... ..._........_........ ....�._.,_p�.... ..._..._.................._....... <br /> T!.e work to be executed by._.........-.__....��..a..-'R�>........_.................PIun:Uer <br /> st.te sizc ot tnp. J . <br /> .��..�....Tap to bc insrrted i� Uie main. �� �/('� <br /> ................R'atcr closet �Vy��� �[ ' <br /> �� � � <br /> -.�...........L'nth ���J, <br /> ................Urin ul <br /> .�..�........Plain f:.ucet inside <br /> '-- <br /> ................S:dc �vallc washer <br /> � <br /> ................Hosc Lib outside <br /> ��...Hosc biL for Luilding Purposes � <br /> ._.--.-.....Hos,; biL insidc . 'i� <br /> '--.....BiU for staUle contamiug...................stall............� <br /> ..._—..-.....Number of perso�.s in family <br /> ...5........Nnmbcr of rooms in building <br /> The premises are to be used ns n.. . . . . _ _................_. ' <br /> � n ......... .. <br /> Tlie uwner of :i�e prer.�ises is.....�GT�.....�....�...:_._............. <br /> �.. ...... <br /> ThenFent is................................................_.........._....._..................................._......._... <br /> This upPiicntion, althou�h signed, ;hall not be binding upon tlic City, until <br /> : :oted by the Superinten cnt of tho W te Department. %;� <br /> � ., <br /> Signed.......... ..��4'���L�✓...........__.... .. icu�t <br /> , PF}� <br /> . /� / <br /> �cpted........,e....�...��.192...... RY-... .L:t�P.�... ��/�"�...._�\ . <br /> � Su n cr.dent <br /> � <br /> r <br /> n- <br /> �1 <br />
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