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3319 GRAND AVE 2016-01-01 MF Import
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3319 GRAND AVE 2016-01-01 MF Import
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Last modified
5/3/2017 3:37:02 PM
Creation date
2/20/2017 8:50:26 PM
Metadata
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Template:
Address Document
Street Name
GRAND AVE
Street Number
3319
Imported From Microfiche
Yes
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e„�� � .,�. � r ;; �-v-ia.�-41 �.•,- (,.�4 ��i <br />� ;, • <br />W. D. Parm �—If00—E.P.Co.—G-2G-2d <br />City of Everett--Water Department <br />APPLICATION FOR WATER <br />All Ulkinks must be filled in or crossed out <br />F.Vcrett,. ........ / ............192. o. <br />............. �� �....................... <br />TO TF{E SUPLRINTGNDBNT OR TIiP \l!ATF.R DEPART\fENT: <br />CITY OF �V�RCTT: <br />I hereUp nPD�Y for the use oC �vnter iu ��ccord;mce ��'ilh thc rules and regu- <br />Intiuns of thc «'atcr Department, for purposex nnd fistures stnted belo�v. <br />During lhe time thnt nny of the �eater mains mny be tnken up bY renson <br />of nny imProvements nuthorized Uy the City of F.�•errtt, in or of any street or <br />ulley in which thcy may havc Leen lnid, the City �vill not be mquircd to furnieh <br />water duriag the Progrese of such impro�•ements to any wnsumer wliose supplY <br />m�y thus Lc cut off, or be lpinblC for any dmm�ges fur its fnilure ao lo da. <br />Application No.....�..�../...._r ................. <br />�' • . Add.. <br />Block......._.�...L....�...._..._y....... Lot..........�.V....... ............._................. .... <br />. ............. <br />No ...............�✓'.... .�-t.....�...F.......G� ..�... .�.G�.. .........-... ��..Street <br />_ . _ ---- ................ ... _... ..................... _..... <br />The �eork lo be executed by .............../ .. ._._... _...._........... .�...._....... Plumber <br />Sta�t,e/ y{ze of tnp. ��� " j v- � <br />., .�1.. .��..Tap to Ue inserted in the mnin :-� � o'V <br />/ � �:,� _ �D <br />................Nnlcr doset ��. _� / ' <br />C <br />................Bath �i / �-�."'(, �� ; ; �. �' �' <br />................Urinnl ''y �Of, �/1/ `y' 1,�� -� . <br />,f� � <br />................1'Inin tnucet insicic f�f%!�' j� � 6 J ' <br />................Sidc walk �ensher �'"�,, ly�r �� <br />................Hosc bib outsidc f �+� <br />................Hose bib for building purposes `'�•.� l <br />...._.........Ho_e bib insido ``'•.. <br />................Bib for stnble contnining....................stnll.................... <br />................A'umbcr of persons in family <br />................Number of raom: in building ' <br />TL+r. premises nre to be used es a.......__._......._ _ ......................_... <br />�n_�� � �� _ __.......t.,.�..... <br />The owner of the Premises is.h.KX_a-�.. `: =re='l.�f' � �-� <br />Thengent is....._ .............................................................................................................. <br />This nPP��cation, ulthough signed, shnll not 6e binding upon the City, until <br />n��cepled by the Superinte Icnt ot the ter Depnrtnent. <br />. S/igned....��.r..... ...�..r...._�.. ._ 1. . ...................APPlicant <br />AecePt�d. ..(0...-.U.._-..._.....192�.�... IIy.. .. . , <br />� . .. .... ...... <br />� -Superintendent <br />
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