8017 W GLEN DR 2016-01-01 MF Import

_ :.� - , < i , � W.D. Fo�m A /,;�i CITY Oh EVERETT WATFR DE?ARTMENI' APPL�C�TION FOR WATER All blanks must be fil]ed in or crossed out Evetett......................��_�'.'.�..._..............._.............19''.::. TC' THE SUPERINTENDENT OF' THE WATER DEPAR4'MENT: CITY OF EVERETT: I hereby apply for the use ot wnter in accordance with the rules and regu- lations oC thc Walcr Department, for purposcs and fixtures stated below. During tl�e timc lhat any ot thc watcr mains may Uc taken up Uy reason of any improvements authorized by thc Ci�y of Everett, in or of any strect or alley in which they may}�ave been laid, the City will not be required to furtush water during Q�e progress of sucl� improvements to any consumer w6ose su�- ply may thus be cut otf, or be liable for any damages for ils fai]ure so tu do. Application No..J..�� ........................... Block....................... �...Lot........��................... Add........................................... ........... . No..........��.l....'.,....��,•;�-,�C—..—.............._...................., .......Street ...................................................................................................................................................... The �vork to be executed by.......................................................................Plumber Stale size ot tap. .�,; �.._Tap lo bc inserled in the main. �..-. ........Nater closet ,; �.....`......Bath L� '„_ � . ................Urinal � � 'E,<�'r�✓-t�/" . � i� ................Plain faucet insidc . .. �0 ........._.....Side wnik washer � � �' '�l . : ,, ................Hose bib outside 1�. ` � " , L�� ' ................Hosc bib tor building purposes �r' � i; ................Hose bib inside ��''1 ��-(1� �y � �.._,�:_.�. ................Bib tor slable containing...................stall...._�....... � -- ' : � ...../...........NumUer of per;ons in family �-4'.........Numbcr of rooms in building Thc premises arc to be uscd as a......_..................._......... .......... ..__..... . ___..__..... The o�vner of the premises is..................._........................_........ ..__._......_. .__. .__. Theagent is_..............................................._.......................................... , .......... ............. This application, although signed, shall not bc binding upon thc City, unli] accepted by thc Superintendent of thc Water Depardnent. /� i /;�, J Signed.�.....:./.c.�_2:.r.f,......,:,.<.....�r::......s.`-:�tti; '-.�.r.....APPlicant �.. ' Accepted...............___.................._..1P....... By.........................:.:................._.............. Superinlendent. � . . � .':•;q.-_RSTs!:4fI�:�M!�C6l�i. ' _� -.