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1211 PACIFIC AVE 2016-01-01 MF Import
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1211 PACIFIC AVE 2016-01-01 MF Import
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Last modified
2/25/2017 5:22:46 AM
Creation date
2/25/2017 5:22:34 AM
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Template:
Address Document
Street Name
PACIFIC AVE
Street Number
1211
Imported From Microfiche
Yes
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:"�..�`a, ❑�� �4- �s- /�J. ��.-,t.� .lo— ca — 'v.i CL�::�- <br /> tt'.U.1'orm 1—I&10—F..IICo.-L-Y6-Y� , • <br /> City�of Evei•ett--�Water Depai•tinent <br /> APPLICATION FOR WATER <br /> All Ulanks muet be filled in or crossed oub <br /> E t�e rM t�............_....�_�. ...192..:c� <br /> ......................................_ <br /> ]'0 T1iE SUPER(I�TENll1iFT OP THi�: R',1TISR PPPAI:T➢tENT: <br /> CITI OP lVEi2ETT: <br /> 1 hereby npp:g fnr the u=r at tcatcr in :�ccordance wilh the �vles and icgu- <br /> Intiuns of the Naler Department, for pm�pr,acs nnd fixtures stated hcla�a. <br /> lluring the time lhat nny of thc �vater mnins may he takcn up Ly rcason <br /> of any improvements authn:ized by the City of Gcrret., in or ot nny strect nr <br /> ulley in �ahich they mny hace been laid, the City will noL be iroquired to :urnish <br /> wnter durir.�, thc progress uf such im�irovements to any cm�=umcr whosc suPD�Y <br /> nmg thus-Ac cul o}t, orv`bP, liabl�nr ar,y damngcl-; fur its fnilure su lo do. <br /> Applicntion No.......9.....`v.�....a.._...r..J.... , <br /> Rlock... �f.%: � _ I.ot . .....L.. . ..._. _. Add.-__..___ • <br /> ho....../�,2 /1...- .�.ct cu...t c... ..._s����c _ � <br /> _ ___.._ ...... ... . _ _ __............. <br /> Thc work lo Ue caeeuled by. .. ....._ �.�-�� ._.... .. �mUer <br /> State eize of tnp �� (� ��u.�.�. <br /> � <br /> �-.....__Tnp to Ue inserted in the n� �'�Q�� ���, �Cf U r , <br /> .........._...Nnh. •loset � <br /> � <br /> ................Bnth � �7�"' �Q '� a <br /> ................Urin nl <br /> ...............Plain fnucet inside � <br /> ................Sidc tanik tenshcr ✓ <br /> ................Iiose bib oulside <br /> ................I�oee bib far building purposes <br /> ..........._...Hose Uib inside <br /> ................BiL for stnble containing...................slall....._............. <br /> ...._..........I�umber of persons in femily� <br /> .......... ....A*umber of rooms m buildin� <br /> Thc premises are to be used ns n .. � <br /> The awncr ot the pre�iises �s G�'I��/��.�� ����_'�__,.�_ <br /> The agent is...... . ... .. ...__ .... <br /> .. . ..........._........................ <br /> This anri����e;on, nllhouq signed ahnll not be �inding on the City, until <br /> nccepled ;�p the Superinte� - e \Pafer De rtment <br /> i <br /> Signed...,Y.., :...' ....."_.. _ �....�..... .. � � __..:.......Applicant <br /> _ . <br /> Accepted � ''.... .�" . . ..192...... By . . . : � ; <br /> ... .... . . _..... � <br /> . .. .. . ........ <br /> , Superintendent <br />
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