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925 LOMBARD AVE 2016-01-01 MF Import
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925 LOMBARD AVE 2016-01-01 MF Import
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Last modified
5/19/2017 6:17:50 AM
Creation date
2/17/2017 9:02:41 PM
Metadata
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Template:
Address Document
Street Name
LOMBARD AVE
Street Number
925
Imported From Microfiche
Yes
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\:'. p. I�cu:. 1 ISLO �-I-I.' C. �'. <br />ClTY OF•CVER!:TT==Water Depa��tmEnt <br />�ippti�.:a:tion %�r ��►te� <br />:\II blarhs must bc filled in or crusscd nut <br />Bvci�ntl. . / O, o�. �_____.. . _19d: �' • <br />'fU"PHL:.UPIiRIN'1'ENUEN'I'OF'1'H NA'I'P: )IiP.4N1'D1lN'f. <br />CI7'S' UP IiYIiRET1': <br />1 hereby a�� �ly (or the use of �cater in :iceurdanee �eilh [he mles and regula� <br />�I.�n; uf "Che \Va[cr Deparun �nt, for purpnscs :md Gztures stateJ belmv, <br />During the time that anv o( thc water mains map be tal:en up hy reasnn ��f <br />an}� improvements authorizcd by the Ciq� af Evucit. in or of any strect nr aIIcS in <br />x!iich they ma5' have been iaid. tLr Ciry wiil not hc required tn (urnish water dw'in� <br />�he prn�;ress n( such improven�. r,ts to any cunsumer �chn=e .�rPpl}� mny thus 6c cut <br />nt(, or bc liablc for anp dampsgcs fnr its (ailure so tu do. <br />:lpplicntiun No.•��D � _"'_ _"' <br />�stock --l-So—P � ----I.m—(- �u---'-'r—. _---Aaa .--. __... _.. <br />Ko.__y.2.S_oC�-.o^.-�S�Q'c�.�1'_5-� ._'___..Strcet <br />"fhe work tu be esecirted bv. _'___'__'_'___ . _ ____--' _.. _. __. _ _ Plumber <br />stat � size nt tan. o 0 <br />, „ �i S - <br />..��"'Tap to be inscrlcd in thc ntain. <br />_' _ _ _ _' Water duset <br />_______A�!lh <br />___.___ -Urinal <br />. _______Pl:�in (aunttt insidc <br />. . ___"'_Side walk w:isher <br />_ _ _ _""_Hn=_e bi6 uu[side <br />. _ _____ -17ose bii� for buililing purp���c. <br />....-____Hnsc bib inside <br />..'_______I3ibforstableconlainin�_____ ._._stail - . __ .. <br />_. _ _ . __ ___Numbcr o( persunv in (amil�. <br />-__�.___Numbcr ut ronms in building�J � . / <br />�fhe Premise. are to be usi�d as a_ _C11. -_�L*��wd�dl_____ _.__. <br />Yhe mcner of lhe prrmises is .. �' �' �"' — <br />,� �--L �`�-� -- - -- <br />1'hea8en[is.__._ ...._.....______.-__.. _ <br />7'hi. applica[ion. �IILouKh si�;ned. shall nol bc binding upon thc CiIY. until ac� <br />cepted b�� Thc Superinicndent uf the Wnter Ueparunrnt. <br />:ii�r,ect't/�..-�/Oi-^'��. ---yy --�-----qPPlicant <br />AnrptcJ ..-��'..1S�Z Rpo ��� � �'�. <br />. �_ v�__..._-__.______ <br />� ., i. -nm�n :eci <br />
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