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9002 4TH PL SE 2016-01-01 MF Import
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9002 4TH PL SE 2016-01-01 MF Import
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Last modified
5/18/2017 10:12:33 AM
Creation date
3/7/2017 11:57:39 PM
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Template:
Address Document
Street Name
4TH PL SE
Street Number
9002
Imported From Microfiche
Yes
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N'. 0. Poim < <br />CITY OF EVERE"fT-WATEft DEPARTMENT <br />APPLICATION FnR �ATE]R <br />All Ulanks must bc filled in or crosmd out <br />lverott� _._. " .' _... ..�,9.• "�� <br />l_ _/ _ <br />1'O THE SL!i'I•:I:IS7'F.NDEN'P OF THE R'A'PER DEPAPTnSEN1': <br />C1TY OF EVERETT: <br />I hereby appiy for t.he use of water in acwrdance wilh the rules and rogir <br />l.ilions of lhe \Vater Dcpartment, for pm�poses and fixWres stated Uelo��•'. <br />During thc timc that any of thc tcatcr mains ma}' bc taken up by rc:�snn <br />ot any improcements authorized by thc City of Everelt, in or of any s'�rcet or <br />;�L'cy in which they may have Ucen ]aid, the City will nol bc required to .urni�;� <br />���:�.ler during lhe Progress of such improvements lo any consumer whc:^ s.�P- <br />ph� may thus be cut ot[, or be liable for any damages for ils failure sn to du. <br />Application No........(..!!�..��.Y.-.-r--.r.... C d: c ��(�E hc !- <br />r. <br />I41uck . . . / . Lot /.11. ....... . _ .. Add / t_ i �'._!/ ;J�.: <br />.. .... ...../. .. <br />__. <br />No...... �n�._�Y..-7 `:'0�'-�. ..... . ._....slcecl <br />. _....._ ......................................._...................._..............................._ _......_..........._.._.__..... <br />... 1'hc work to be executed by .............__._.._..___.__. __ ..._.._.__.__. Plumber <br />State sizc of lap. <br />.�......Tap l0 6e insrrted in thc main. <br />�7 � .142-_%i .-/"a"`� <br />........�.....'�Vatcr closet 'L'-: .�� /-, <br />i ( <br />.1_.!.}-...Bath ' ��yr "�� <br />.... �����C'� �'�/ <br />.........._Urinal <br />!,. . <br />.__..Plain faucet insidc - , : <br />, � /�� j ,,- : <br />_. Side walk �vashcr , ,. �� !.� ' <br />_Hose bib outsidc ./;. C" �,� <br />._,, : <br />._.._.._F;osc UiU for building Purpnses '�;;_ ' � '-' � , - � / <br />....._Hose 6ib insidc �'�� � '� %%�' � <br />. . . . _ ��.i:. � �� : <br />. .. ..._....Bib for slab;c containi:.g ...................stail.�'.._,.... _. . <br />� . <br />. . . _...NumUcr ot persons in family ` <br />. ;�"__..Nw.iUcr ot rooms in building <br />Thc premises arc to Ue used as a..._..........._............__..... . _ . . .._ .. ... . _ . <br />The owncr of tlie premises is.._._. ......_____..._.......__..._........__._.____.. __ .. <br />T;ie agent is ... __._ ..... .. . ... ...._. ._._._......._ ...__.._._._. . __.._.. .. . <br />1'lis applirntion, althou�h signed, shall not bc binding upon the City, until <br />acecptcd by tl��r Superinten'^dent of the �i'�ter Department: <br />8f en d . /.....` �t'•'�.�... .. ��/^-�7 __.. ..._Applic� nt <br />� .� ,n �.... . Y �. .... <br />A�crp;r : . . .. . . _ . . � ... _ _ <br />Supu m(cndr-ut. <br />
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