2010 COLUMBIA AVE 2016-01-01 MF Import

/c"�/a n W.D. Fo�m 4 CITY OF EVERETT-WATER DEPARTMENT APPLICATION FOR WAT�R All blanks must be filled in or crossed out Everett�................ ......._.._...�.�..._��...................19_�l� TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: CITY OF EVERETT: I hereby apply for the use of water in accordance with lhe rules and regu- laliuns of the \Vater Department, tor purposes and fixtures stated bclow. During thc time that any of the waler mains may ta taken up Uy reason of any improvements authorized by thc City of Everett, in or of any strect ar allcy in which thcy may have becn laid, the City will not be required ta furnish water during lhe progress of such improvements ta any consumer �vhose sup- ply may thus be cut off, or Uc liable for any damnges for its fa:lure so to do. � %L�r fT �%� Application Ldo-:f19.-�./.....d.:...... . � Block.........�.L!.....................Lot......_�.'��..C................... Add......................................._.. �C: a P.l,t �.c.z...�. �..G.....�.....:........._Strect No.................G......:. 1....................... ... �. � ....................................................................................................................................._............... The work to be executed by.......................................................................Plumber Slatc sizc of t�p. ................Tap to be inserted in thc main. ................�Valcr closet � , , ...�/ Bath • v , ' ......... ;./. ' L � � •�/ ��'`"z—C' �i,o�....._ ................Urinal / C ................Plain faucet inside ....._.........Side walk washcr � ..........._...Hose bib outside � S � ....._.........Hose bib for building Purposes : / � �'t 1"' ................14ose bib inside ` . . . c� l � ) .� ................Bib for slable containing................_.stall..........:......... . , ..............NumUcr ot persons in family '"''`-�� ::��_�r / 5___........Numbcr of rooms in building The premises ate to Ue used as a......................._......._........................ ... ..._..__.__. Thc owner of thc Premises is..........._......_............_..................................._. .............. TSeaSent is.........................................._.._.__..........._........................_................._....... This applicalion, althouFh siFnc{};shall not bc bind E upon thc City, unti' accepted by llic Superi tende •-16e•i'lter Departm nt. a,��z��-C_. %y�n.�, Si Sned........ ....... ........ ....................!-.::.`.....................:......Applicant 1 Accepted............................................14....... By............�.................................................. Superintendent.