7611 EASY ST 2016-01-01 MF Import

�-�'f% W.D.Form 4 - � ,_ GTY OF EVERETT-WATER DEPARTMENT � .APPLICATION FOR �UATER All blank� must be filled in or crossed out " / Everclt�.................._......�...::�..,5.........................._........_..19..�:�.:� TO THE SUPERINTENDENT OF TIiE WATER DEPARTMENT: CITY OF EVERETT: I hereby apply for the use of water in accordanee wilh the cvles and re^,u- lations of the �Vater Deparlment, for purposes and fixtures sta.ed bclo�e�. Durin� the tim� lhat any of inr water mains r,:::•• be taken uP US' rcuson of any improvements autharized bv thc City of Evcrett, in or nf any street or alley in which lhey may have becn�laid. lhe City tvill not be re�uired to furnish �valer tiG.^ltl� IIlC pru6ress of scch :mptovements to any consumer �vhose snp- ply may tlws bc cut oft, ar be Iiablc for any damagcs for its failure so to dn. Application No...��....:�.�....r �.- s�,..G, � /u� . . .:.ti Block........................./.........._...Lut....._......�......_......�`. 1C8di.��:.�t�-"..... -1`�--- � _..._......_. No....................'�......(l...l..i�...._...F,.�..G�:�.:tl......�S'................_...Street ._____......................................................................................................................................... 'Tl�e tvork to be executed by............._.._................._...........................___Plumher Statc si�c of tap. .._............Tap to be inserted in thc main. y!` ...Nater c:oset ` � ��,: �G -•.c� !/� � 1Ut . . .<�. ,� , -�. . . � t� ................Urinal ' � ._. ._.............Plain faucet insidc _.._........_Sidc walk washcr _.........._..Hose bib outsidc ' � ._._..........Hesc Uib for building purposes r �,� _..........._Hosc bib insid� ��} ��,, . ................IIib for stablc containing...................stalL................... , � ._....,........Numbcr of persons in family � � � - . ..��'.......NumUcr ot rooms in Uuilding � � � ' - ' � ' 1'he prciuises arc to b,. used as a........._.............................................................. .__. Thc owner o[ the Pretnises is...................._..._.................................................____ ... 'Phc agent is....................................................................................._....__..................._.. Tl�is application, althnu^„h s�gned, shall not be Uinding upon the City, until aeceptcd by thc SuperintoSident of t p Matc�epartment. �� . � �fL,.�-.:-�•. 5i�iTc�B._....��..6'�.,?.y...i. ��. .. � ................ .....\.........._.Applicant Accepled...........................................iP....... Sy.................................................................. Superir,tendent.