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6825 SKIPLEY RD LINE 5 2016-01-01 MF Import
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SKIPLEY RD
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LINE 5
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6825 SKIPLEY RD LINE 5 2016-01-01 MF Import
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Last modified
3/29/2017 8:56:46 AM
Creation date
3/29/2017 8:32:33 AM
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Address Document
Street Name
SKIPLEY RD
Street Number
6825
Tenant Name
LINE 5
Imported From Microfiche
Yes
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� �. <br /> N'. D. Form 4 I500 J-1-17�,p, <br /> CITY OF EVERETT=�Water Department <br /> Application for Water <br /> AII blanY.s must bc filied in or crossed nnl <br /> Everel�.- ..'._'_"_'__".�� f .""'_�91 Z� , <br /> Tq THF,SUPERINTENDEN7'OF'THE WATER DEPARTMENT, <br /> CfTY OF EYERETT: <br /> 1 hereby apply(nr the nse of watrr in:¢coNance with Ihe n�les and regula- <br /> thms n[Thc Water Departm:nt.fnr purposes and fixmres statcd bclow. <br /> DurinK the time �hat any uf the watrr mains may be teken u9 by reasnn o( <br /> any improvements authorized by thc Citr of Evcreft,m or o{ any strcet or allcy in <br /> ���hich thcy mas' have been laid, ihc Cpv u�ill nnt bc mq�drrd tn Iurnish water durinK <br /> the prngress nf auch improremenis ta any cnnsumer whece supply may ihus Ar cue <br /> nf(. or be Iiahle for anY damnkes(nr its failure so to do. <br /> Avnticntion No..---7.Z• / <br /> .. '_ "'.__ . <br /> HLxA .______-__ . . _Ie�L_.____.."____'__.Add�d-P_-�i._._. <br /> No.� /_ .�Q � � _.�..�.5'_Sircel <br /> '_"'_"'_'..."_"_ ' _1_�_'_.. : <br /> -�t'L9--C�-:t___.__..___.____ ._._.__ <br /> The work to be executed by �______. ._ __ Plumber � <br /> __'__ '______..._. <br /> s3 tc sizr ur cap. — <br /> __%'I"'"Tap lo he itlscrtrd in thr maia. / _/ ' � b <br /> ."—"-_Water closcl <br /> .__._____Bath <br /> '__ _" .Urinal <br /> ...__'____Plain faucet insidc `. <br /> .—_______Sidcwaikwashcr '� � <br /> � '_'__.._Huschiboutside - <br /> ""__.__Hosc bib for buiidinK P���noses <br /> -----____Nnse bib inside <br /> ._'__'._'_I3ihforxtablecontaining____._ ....stalL__ _._ <br /> ____.__'_.Numbcr ut persons in fnmily <br /> _.._______Number n(nwms in builAing <br /> The premises are to be used �s a_.__._____ <br /> .____._.. .___. <br /> _ _' <br /> ___-' <br /> 7'hr uwncr of thc premiscs is _______________ <br /> ._. _ _.._._.. <br /> _ ._'_'_____-_. <br /> The agenl is .__._"' <br /> ._.. ._."__'_" .... ._ "_""_'_ <br /> This applicalion.ahhough siAned. shall not bc binding upon thc CiISS unlil ac- <br /> ccptcA hy Thc$uperimendenl nf thc Wntcr Uepartmcnt. <br /> SiQned_.,_�__...:."'.__. .. _ __._.____Applicant <br /> Acrepicd. _.._ ._______191 B <br /> ,-- . ' Y."'_.____.__'_'_. <br /> "� � � ,6� i.xrini�nczv _- <br /> [�H ;..•l ' ���y�% L. <br /> ?`i[—.. .._ ._. .._. <br />
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