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10620 21ST PL W 2016-01-01 MF Import
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10620 21ST PL W 2016-01-01 MF Import
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Last modified
4/10/2017 8:49:17 AM
Creation date
4/2/2017 4:24:19 PM
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Template:
Address Document
Street Name
21ST PL W
Street Number
10620
Imported From Microfiche
Yes
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. ,, : ; <br />Tap I�o...'C.':�.>:..'P../._�L..-- <br />MUKILTEO WATER DISTRICT <br />SNOHONJSY. COU'JTY, VJASHINGTON <br />3� <br />APPLICATION FOF. V��ATER <br />All blanL•s must bc fillcd iu or trosscd out <br />' _ -. <br />\fuLilteq 1'�nsliin3ton, _.. .. .......�.i ' !........ .__. ..., 19.�....? <br />TO TfIE SUPEI:I\'PE\llEKT 01' TFIL !�fL'�I:ILTHO N'ATER DISTRICT: <br />I hureby appl}' for the use ot �cater in actordantt• w1i� thc rulcs and re.gulations <br />o( lhr �[uLil«•o 11'atcr Uistrict. <br />Uurinc tLc timc t6at mn' of tLe �raicr mains mac bu takcn up bp rr.ison of <br />:�m� impro�'cment autLo:izcd in� ti�r Uisvict in ur of anv strce„ road or allcy in <br />which thcp map irn�r Lcen laid, thc Disviet �cill nnt bc rcquired ro(urnish �ratcr <br />durinv thc prnrress o( surV: impro��cments to m�y ronsumcr �.'iiosc supplp map thus <br />bc cut o(f, nr Lc liablc for :inp damagc for its G�ilure so to cio. <br />AppLcation \o. .... . .._ � <br />IllocL � Lot/ i—...� �'__. idd. _._ _...__.. ......... <br />I�o....��(���P���� � .._._ ...... Suc�t ._... ..._.. ......... <br />__ �DGt.20_ ZI �._�'L t.J._ _ _ . ._..... <br />___ _ <br />___ <br />__ _... <br />Stat�nl�tsp. � . ___.inch. <br />g, �� ... Las Uccn rccciccd «�id� :his applic. tim�. <br />. ........_ .......__. __ ... <br />......._.__. , <br />......... S¢pcnrttcnden:. <br />'Che prcmises :ue to be used as <br />Thc o�vuer ot thr prcmiscs is..._._......._ .........................._................._.__......... <br />TLe. avent is ._...... ___ ... ............ __..__.. ......._....._. _....__.... <br />'Ti�is apnlir.r.ior., althnugh <icncd, s6al1 nm bc bindini upon thc Distric[ until <br />arre��u•�i Lc th<• Sunerintendrnt o; the \fui:ihco 1\'ater llistri/c(. <br />/ �%� <br />SiSucd���.iL%��/_���L/�l�C/'..c............ _O:untr. <br />Acceptcd _..._ _..._. . __ . , 12 . __.. U}•.. ...........__ . ... <br />........ Supc�intcndcr.t. <br />
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