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8321 52ND ST SE LINE 5 2017-04-17
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52ND ST SE
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8321
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LINE 5
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8321 52ND ST SE LINE 5 2017-04-17
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Last modified
4/17/2017 7:32:51 PM
Creation date
4/14/2017 2:42:12 PM
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Address Document
Street Name
52ND ST SE
Street Number
8321
Tenant Name
LINE 5
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_ _ , ��v. �y. �-aa - �: o r)f' — <br />� ar <br />��/�. D. Form 4 ISUO 3-1-1^ C. P. � <br />�ITV OF EVERETT=-Water Department <br />Application for Water <br />All blanks must be filled i crossed out <br />� <br />Evcret[..._'._____�__'_"'_'__. __�e2-�791�-G7. <br />TO THE SUPERlN1'ENDEN'P OG THC W'.R DEPAI'<TMEN7', <br />CI7'Y OP • / ETT: <br />I hereby :.pply fnr the use of weter in :mcordance with [he tvles and regula- <br />ti:m. nf The Water Dzpartment, (or purpoxs and fix[ures stared belou�. <br />Durinq t6e time lhat any of the w�tcr m�iins may he talcen up by reason of <br />any improvements au[horized by thr Ci[y o( lcerett, in or nf any strce[ �rc alley in <br />�rhich [hry may have becn iaid, dic City will not he rcquired to (urnish water during <br />the pro�ress o( such impruvzments tn any rnnsumer whose supnly may [hus be cut <br />uf(, or bc liable (nr any dam;�ges for its f�+ilure so to du. <br />'7 � <br />Applirn[inn Ku.__J_Z.9 !_____ <br />'Aiuck .--------' --LoL-" -o—'-----------'Add----�. _--�--�---�---- <br />v�. %�le�v ��e o-.+�U _f�b-� .. s«��� <br />'fhe work to be execuled UY--- -'— -�-------- --------- Plumber <br />S[atc size nf tap. <br />_�3 �l <br />�____Tap [o be inserted in the main. �/ ��) <br />_ _ _ _ _ _ _ _. �9ater close[ <br />--'-'--'--Bath V """`cc;`=�L. <br />� i ; _'^�:':-`:. �.. <br />-------- .Urinal �fjrY� � l� •,,;�, <br />_._---___Plain faucet inside J/��� /1 � \ Ir,S �� <br />.-- _-Sidewalkwasher ���4� ������'Y��"'" ��; <br />. _Flosc bib outside I` � �j ,7 �Z�� � ��� <br />_____ \ '�� IIT, � µ !F i� <br />---'__'__Huse bib forbuilding pmpnscs � F�_�j, � �� <br />'__._.I�Iosebibinsidc � � ��C.�. <br />__'__'____Bib ior staUle con[aining..__'___ _.. <br />---'-.----Numbcro(personsin t.+mil}, <br />Num6er of rooms in building <br />'Chepremisesare[obeusedasa___._.__"_""___"'..'_'_'_____.__'_ _____. <br />1'he nwner of [he premi<es is _""' __'..__ ___. _. -... _ _.. _____ _'_""'__"'_.... <br />'fheagentis.________...____.__.___"'_' _._ _....____""..____'___"'_ <br />7'his apPlica[ion. al[hough si;;ned, shall not 6e bindinS upnn [Fe City. iin[il ao <br />cep[ed hy "Che Superintendent d lhe Wn[er Uepartme� t. / <br />Signed/�%'�_, _ ;___ .__.__ .'� �/�'.�Aa;:�ican[ <br />Acccpled_.�_. ��__1� Ry_��/__'.'_"'____' <br />, 1 Superintenaent <br />�` <br />/ r�� _�./ 8_ i�-_�-�•-..+) <br />
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