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4224 RUCKER AVE 2016-01-01 MF Import
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4224 RUCKER AVE 2016-01-01 MF Import
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Last modified
5/11/2017 9:21:51 AM
Creation date
3/9/2017 12:57:43 AM
Metadata
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Template:
Address Document
Street Name
RUCKER AVE
Street Number
4224
Imported From Microfiche
Yes
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Fn�rv 5-i'i— "I <br />" � . ��VI�`� ! �J _ ... � <br />' W. D. 1�iim � I500 d-1-1'! C. P.. . , � <br />CI�Y OF EVERETT==Water Depari��ent <br />• Application for Water <br />All blanks musl Uc fillcd in or crossc�out � <br />- y i �� (� <br />Evrrett.-_!_. �'�'ll. _._ �� _'____ _____.__.191_. ___ <br />T�l THE SUPM:RIN7'IiNUliN7' Oi� 7'Hli 1VATER DfPAN7'AtIiN'1'. <br />(;I"1'Y nI� E`JIiRF,'1'T: <br />1 hereby apply fur the use uf wnler in accordnnce with Ihc rules and rrK��1a- <br />tiuns uf The \Vatcr Uepartment. fur P��rposes and fislures slatcd below. <br />During the timc ihat :my ai thr water mnins mar bc taken uP by reason of <br />:mp improvemenis authorized 6y thr Cib� o( Everell, in or nf any st�cet n� alley in <br />o•hich Uiey ma)' hnve bcen laid. Ihe Ciq� will not be n�uired to lurnish wale• during <br />the progre,s o( such improvements tn am• consumer whose supp�>' may thui le cut <br />of(, nr 6e 1ia61c fnr nnY dJamaK�s (nr its failure so la da. <br />APPlicnlinn No..'_'(_�!_.� l'_" <br />llock .c,�_„�_ -__"Lq�l �-�.'_- Add..._-_._'--_"__' <br />//'� .. . / 1__i__' <br />ti•� -_._ ._�_.,'_L-_�._ l��G(:CA �-�j(� _Streel <br />_____.._..._..._ _' ' _'"""'"""'"'___"""____""""_'._""_"""_"'__""_"_' <br />"1'hew'urAlnbecxetuledby._..""_'_'."''.._ ".."-__.-___-'__ Plumber <br />Sta/te/ sim uf tap. <br />J lJ_ '�A� tn be inserlcd in lhe muin. ,.p <br />"' �____SVatcrdnset - � '�. .� <br />_ . �'—'.13a1h <br />.. .--. Urinal � ' . <br />__Pinin laucit insidc � � �� <br />. . _. � � � �\ ,v \� <br />. _"'SiAe wall: wnshcr f���. \� .� ^�4 \; .,,.. <br />__Huscbibautsidc � Q �'�1"F <br />_-____ - 7 ,� A � � � �, <br />..'_'__. _Ilnsc bib forbuilding purpo+es .„ �� � i• '. . j <br />il �` i.��il <br />._-__._..Hosebibinsidc � �i, '�{ <br />__'___'Iiiblorslablecuntaining___'._'_'•,.cttll..___ . �" ,�('r,%� <br />- � '� ; `���,';F <br />_ _' _. _.Numbcr u( persuns in fnmiiy . - �/'. <br />____.__..Numbcrofroomsinhuilcling � - ��� <br />Thc premises arr to be used �s a _ .. _. . -__ _"_"_"''' "_-" �'__ ""' '_ _" <br />The owneraf lhe premisesis '___'_'-____-....- . "_"_ '_'_"'__.'__ <br />Thc�Rcntis.__'_....__..'_"____"""_ _ _ "__""_'. ....__"'_' <br />'1'his applicatiun, althouFh signed. shall no1 bc bindinR upnn tlic CitY� ��ntil ac� <br />rrplcd by 7'he SuperiNendent u( lhe R'nter Uepartment. <br />. � i . , <br />SilSned __ G�"> _' C �r�-�'_�: :'. � -'� �'�'-�..._.ApVlicant <br />.�.' _'._ _• �,s.�'_ <br />/ ' � "_ <br />� . �1 � <br />nca�n���r->`-=7---1•'l / H`'--� .- --�-------------/ <br />. 3u; �i ImrnLem <br />
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