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2714 21ST ST 2016-01-01 MF Import
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2714 21ST ST 2016-01-01 MF Import
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Last modified
4/21/2017 12:45:10 PM
Creation date
4/2/2017 4:34:50 PM
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Template:
Address Document
Street Name
21ST ST
Street Number
2714
Imported From Microfiche
Yes
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. � , <br />• ,� :. �. <br />�� ;;.:,. <br />W. D. Form 4 1509 �-I-17 C. P. ����,t,'• <br />CfTV OF CVERETT==Water Departrnent' <br />Aplplicatian �'or W�►ter <br />All Llanks nu�s[ bc filled in or crasscd ou[ <br />_-- / O <br />Everett� .._'.___'_'__"'"_'..��'_'_..19('%_'- <br />'i O Tlil? 5UPBRIN7'LNDIiN'C O'F Tllfi WqT13R DEPART�IGN"f, <br />CI7'T OF f VI?RL•'7'T: <br />I herrLy appl�+lur ihr use o: �v:�ter in :iccordanee a�ith the rulea and regula� <br />ti�.�n.; ��!'I'he �V:uer Llep�:irtnr_nt. for purP'�ses and �isuves st.ucd beluw. <br />Um�in�; [he tin:e Oiat :my o[ the a�a[er mains may be taken up by reason of <br />.mv ininrnvements authorizad b}� thc Ciiv u( 6vurett, in m' uf :my strueL ur allc� in <br />w':ich they ma7' have been Iaid. the City �ci!I not be required In fiirnish water durinF <br />the Pru�;ress n( s�:ch imprnvements tn aib' consumer u9iase suPPly inay [hus be cut <br />nlf. or bc liablc for :ury /dnma�;pes fnr its failure sn [o do. <br />Applicntiun Nn.___1�..0_./N"_"y/_' �1 <br />lilnck ___'. �`" "'__LoL"_1e`'_" �%-.1g_..Add�.�a�-�.A'-Cl3/?� <br />1u._____.__ /✓-"i_�f'�'_.__ _.�.�'`�:L'..___...Strcet <br />__._'.__._._____'_ . ________'._________,_'__1________...____-_'___._.______ <br />"!'he �cark to be cxecuted by _ _ . . _ _ .. _ _ _ _W l..S _�i1-Ch-_ . _ . _ _ _ Plumber <br />State sia.e �d tnp. <br />.�z, ��___Tap In b.� insertcd in Ihc main. <br />'___'_�_._\V�uc[ cloecl <br />.'_"' �'_- Rcrth <br />.. _ _.- .IJriral <br />_ .______PlainLwmlinsiJc <br />.. _'_. _'—Sidc «�all: washcr <br />_ _ __'_ _._Hus�� bib ontside <br />_ _____._..Ilose bib forbuilJing pwpn�cs <br />_ ______Hosebibinsidc � <br />; �.:�� .�--' �".; i.' ,, � <br />fr' ��' '� �' ' r . � 1• ��•� . <br />�� IA�,� �f '���. �i,;� . <br />�. � " ��` <br />'a 4\ pqr � / �.Ri l'� �!' <br />��` ' :�\ - '� � 'v <br />.�\y ��'� O/ <br />��°��� =%'! �b/ <br />______ .__13ib(orstablecnntaining-__-_._. ..st,�ll_. __._ Ilr,� � <br />i <br />_ _ _ _ _ . - - _ . Nun+.ber u( persuns in f: mily <br />. __�___.Numbcr o( rooms in building . d � � � <br />"Phe orcinfses are eo bc used as a _.._- _��a.L.i�C-�-��,-- ./.�.. �. __ _ _ _ .. _. <br />Thc rnvncr u( [ha preinises is _�,_Y_�C1A.����1. ���-c-I`i-L'.�_ <br />�'__ <br />'fhe a4entis .-'-'-�--- ------ --------- -- ------' ------""'-�---- ---_ . <br />7'his apPlication, :illhaugh signed. shall not 6c hindinE; upnu U��e CitS'. until ai-� � <br />cepmd bY The Superin�endent u[ the 1Vater UepnrureiiL �. <br />Signed_�Yl�_�t�'�.• �'.-:+'.i._ .�_..."'__'_':1ppli:�uit <br />/' � i \ <br />Ancpted__ .' '---':_._'_l9l fi� -""'."_...._"__. ..-__....... <br />r�..,, -._.. <br />
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