2202 EL CAPITAN WAY 2016-01-01 MF Import

/��' W.D.Form 4 CITY OF EVERETT-WATER DEPARTME�lT '' APPLICATION FOR WATER All blanks must be filled in or crossed out Everett................. % .G�<<....r�................191..Y .........�� TO TFIE SUPERINTENDENT OF THE WATER DEPARTMENT: CITY OF EVERETT: I hereby apply for the use of water in accordance with lhe rules and regu- ]atinns of lhe \Vater Deparlment, for purposes and fixtures staled below. During lhe time that any of the tvaler mains may Ue taken uP bY reason of any improvemenls authorized by thc City of Everett, in or of any strect or � alley in which thcy may have been laid,thc City will not be req�ired to furnish tvatcr during thc P�ogress of such improvements to any consumer wltose sup- ply may lhus be cut oft, or be liable far nny damages for ils failure so to do. Application No...�1..��.L.......��2. � � ;�_..,„Tf+t I✓ ('v� Block.................... .................Lot........................................ Add.......................................... �' � � •� /I No......l...C�.�._��'.a,._:�......�'./�1:r6�:.6�.c-.��:f...Street ...................................................................................................................................................... Tlie work to be executed by.......................................................................Plumber State sizc of tap. ....�....�..Tap lo be inserted in the main. ................Watcr closet � 7� � ................Bath �,�1'.1+:"p. ,..� �� t' ................Urinal . CL ., ' ................Plain faucet inside . ........Sidc walk wastur � � � � � .............Hose bib outsidc ��/h��4 � ................Iiose bib far 6uilding Purposes�,.,,�� ` ��b ................Hase bib inside ..:�.�. � � �..� ._._..........Bib for slablc containing....................stall.................... ................Numbcr of persons in family ................Numbcr of rooms in building The premises are to be used as a................................._........_........._...... ......._._..... Thc owncr of lhc premises is...................._._................._............_...._........................ TScagent is...................._............ ..._...............................................__........................... This application, althouFh signed, ehall not bc binding upon the City, until :icceptcd by the Superintendent af the �Vater Department. /�� • � ^ Si.cnecl..:f:!!�..::2.��._`�-.,.y��:.trl��.._`z cL<:e...�.�.�........Applicant . , � A^cepted.._.__. _ . . .._...1P..... BY�......................_�Icu . • ._...___. ._ . ................................... . ' Superintendent.