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1215 MADRONA AVE 2016-01-01 MF Import
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1215 MADRONA AVE 2016-01-01 MF Import
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Last modified
4/10/2017 8:20:05 PM
Creation date
2/17/2017 10:39:47 PM
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Template:
Address Document
Street Name
MADRONA AVE
Street Number
1215
Imported From Microfiche
Yes
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c-�„-�-�r � �i : r it , �_�1 �..� � �_ �� -� -y r•�n,r, <br />\V'. D. Form �1—L'•nu—G.CCo.-6-26-2A <br />City of Everett�Water Department <br />�'I ,I�ATION FOR WATER <br />A1l Ulmiks nmst bc filled in or crossed out <br />i Everett,.........�.-.-`. �...... ... � ..............................192...l.. <br />r <br />TO TII� SUPER[NTENDCIQT OF TIII: R'ATER llliPARTNiGNT: <br />CITY OR �V�RGTT: <br />I hm•eby apP�Y for the use uf trnter i� eccordnnce �vith tlm rules and tegu- <br />Intimis of the Ntaer Depnrhnent, for pm'puses and iictures stated below. <br />Puring !hc timn that nny of lhc water mnins may Ue taken up Uy rcason <br />of any improvemenls authorized 'ny tl�e City oC Bcerett, in or of nny sLreet or <br />ulley in which ih^p may lia�•e been ]aid, the City will not be required to fumi,h <br />�vater during the progress ot surh improvements to any consumer whose supply <br />m:�y thus 6e cut ofS, or�e�iablr� for uny damnges for its failure so to do. <br />- <br />7 ^� <br />Applicati,.in No..........._........6 ................ 2..> <br />BloclNo....L.C.C.�-�P�"�-/..`.F[c.i.frr��..._ ....:........:.... Adu_.._............................._...... <br />........................._'. ._ Lo ......., (,_:' i,.. �/.I: n.: r , : --._. L%. � < . <br />.......... .... .._ . .....................Street <br />Tlie �vork to be executed by .............e.`.�.`.�'��_�..._..._.........................._.PlmnUer <br />�t� s�zr. of tnp. i) <br />� ��...Tap to be inserted in the mnin. �� <br />....L........_Wutcr closet �,/ \ '� <br />�\ <br />................Bnth � �y ? �' � '�� <br />-.-�...Urinnl y �'� � <br />�.. <br />.._�...'.....Plnin inucet inside � <br />-:....—'..Side �valk �cnshcr ��f' � . <br />_ v <br />�.. �-� . �\ (' , <br />.....:_...._.I[r�ee bib outside ��- . <br />� i � <br />1 ,._. i <br />'--.-Hose Uib for buildin6 Purpases �. '. =��- i <br />..... <br />,,7'� � .'. <br />. : �.� se bib insidc . . ��� �. � 1 � � - -. ""� <br />., ,�-�� • � .;;c,. �.��t <br />._�.BiU for stuble coutnining ....................st jY..�F-4,��.gT:T' . <br />. IQumber ot Persons in family �� -' <br />..... . ........ .... ., <br />/' , ....... . � <br />....1�...:....Numbcr ef rooms m building ...•�'.�.."....... <br />c -c <. <br />'Phe PTemises nre to be used ns n ...............t�.,r ��h�y ._.._........... .._ �............. <br />The o�cner of the premises is.�. ..._.�.....`C�.__...._ ................�.L...�........... <br />Thcngent is ...................................................................................................................... <br />This npplicntion, altlioug}� signed, shall not be t�inding upon the City, until <br />necept.ed Ly the � crintppdent o e\ ter �rtmr � / <br />Sign .......�././..�...... . .. G.����.c�......./.. ' Applicnnt <br />Aa:epted.......��.r.�...-:..._192. ... BY�s'��/I"�/ 1 .._.... .......' <br />/-�y�uperintendent <br />
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