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1412 36TH ST 2016-01-01 MF Import
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1412 36TH ST 2016-01-01 MF Import
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Last modified
3/31/2017 8:36:36 AM
Creation date
3/31/2017 8:36:33 AM
Metadata
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Template:
Address Document
Street Name
36TH ST
Street Number
1412
Imported From Microfiche
Yes
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� <br /> . �����q � i= r,i ,—i,. <br /> - 1'J. U. Pcnn 4 ISGJ 3-1-17 C.P. �� e.t.�, <br /> CITY OF EYGRET�==Warer �epartment <br /> t'�pplacation for VVater <br /> All blanks must bc filled m or crossed n�rt <br /> ��J O C <br /> fivcrett�.__'_______________ _"___ ..___._]91 _�_._. <br /> 77) TIIL SUPIiRINTBNUF.N'f(d�'fHG �YA'CER UENAH7'bifiN7', <br /> CI'I'Y OF E`/ERGTT: <br /> I hereby apply (or the use of water in acrnrdance with the rules and reF;ula- <br /> �i,ine nf'Che Natcr Dzpartm�nt, tur purposes and fixnn�es sta�ed belon�. <br /> During [he time ihat auc ni the water u�ains may be tal:en up by reason n( <br /> auy imprnvements authorizeJ by t�:e Cit��of G��erett.in nr of any sircet nr ailry iu <br /> mhich they maY have been laid, the Gt�� will nn[be rrquired tn (urmsh aater durin� <br /> �6�: prugress o(such nnnrovemcnls tu any consumer whose suppl}' may thus be cut <br /> ��il. ur be Iiable fur anY damages (•�r its (ailure •n to do. <br /> �7 C <br /> Applicntinn No._"'./.�_. <br /> a "_ __"_" <br /> l31n,�k .__�-.�.,.__' _-_'2�aL_'l '_2—._'____AJd. . _ " <br /> ____ ......... .... <br />� Nu."__"�-�i.�.- .d'��____'. ""_Strect <br /> _"""'"'"____'.."'_"_"'_' '_'_'_""..._'_" <br /> "_"""_ <br /> Thc work to he executed bv___________.__ _______'______ Plumber <br /> State;izr of fap. � ��������� <br /> .�._'___Ca, to he insrrted in the main. �„ ' C � � <br /> _________.iVate� �lo=i�t <br /> ""__'_.liath <br /> . .-.-_ .Urinal <br /> .-___. _.�:laiu /:m���t in=�d�. <br /> .- '_-"_'Sidc wall: �rashcr <br /> .__._ __._I�u;e bib cutsiJe <br /> .--__. _ .Ilosc 6ib tarbuildini; pwposes <br /> -.-_._. __.Ilnse bib insidc <br /> _-__'._.._I3ib fur s[ahlc cor.[aining...._.__.._.st��ll <br /> __ ____ <br /> ____.____ NumLcrof persnns in :amilv <br /> -'__._____Numher of ronins in huilding <br /> Thepremisesarr[obcusedasa_____ _____ _ ______'_ <br /> -_._ _. .____ _.__. I <br /> 7'henwneruf[h•.Premise= ia ____________ ._ ._.. _ <br /> - - ._______.___.. <br /> The :�Hentis_____..___..__ _____. __.____ __ . . <br /> '_' _ "__'. ._.. '_'_""__ <br /> 'fhis :ipplmntion, ai[hough siGned, shail nol bc binding .pnr thc CiIY. un[il ac� <br /> o�.p[rd Uv The Superimm�dent n(tlte SVnter Department. <br /> Signed--�-- �I��—!-�-�-�-_� -`��____-Applic��i <br /> � ' G'e�.�ur <br /> �,<<•,���•�i// �s;�� is � � <br /> �O � / ��� — — _ _ <br /> ?�=�:�;_.. -�:� <br /> i <br /> ; r. <br />
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