1615 SE EVERETT MALL WAY 2018-01-02 MF Import

■I 112'�;' W. D. Form 4 CITY OF EVERETT-WATER DEPARTMENT APPLICATION FOR WATER All blanks must be filled in or crossed out Everett ......................... �Zz.! e.... P....................... 19L. TO THE SUPSF.INTENDENT OF THE WATER DEPARTMENT: CITY OF EVERETT: I hereby apply for the use of water in accordance with the rules and regu- lations of the Water Department, for purposes and fixtures stated below. During the time that any of the water mains may be taken up by reason of any improvements authorized by the City of Everett, in or of any street or alley in which they may have been laid, the City will not be required to furnish water during the progress of such improvements to any consumer whose sup- ply may thus be cut off, or be liable for any damages for its failure so to do. Application No/f3.e .................. Block ........................................ Lot .......................... _.............. Add ..................................... _._ No ........... 1?_,-? ��`'"q�.....................................Street The work to be executed by........................................................................Plumber State size of tap. . R..."..Tap to be inserted in the main. i ................Water closet ................Bath ................ Urinal ................Plain faucet inside ................Side walk washer ................Hose bib outside ................Hose bib for building purposes ................Hose bib inside ................Bib for stable containing ......... ........... stall .................... ................Number of persons in family ` ...............Number of rooms In building The premises are to be used as a...................................................................... ...... Theowner of the premises is........................................................................................ Theagent is.................................................................................................................... This application, alth signed, sh�1]-got be finding upon the City, until 1 accepted by the Superi tt of the p7Fat"er D ent. Signe�cGco- C ....................Applicant Accepted............................................19....... By .......................... .......................................... Superintendent.