210 ELM ST 2016-01-01 MF Import - Laserfiche WebLink

�� w.o. Fo�m a CITY OF EVERETT-WATER DEPARTMENT A�nPLICATI01lT FOR WATER All blanks must he filled in or crossed out Everett�.........................S{.�.�j....................................19_�^:V. TO TIfE SUPERINTENDENT OF THE \VATER DEPARTMEhT: CITY OF EVERETT: I hereby apply for the use of water in accordance�vith lhe rules and regu- lations at thc Watcr Department, for purposes and fixWres stated below. During tlie time lhat .ny ot the water mains m�y bc taken up Uy rcason o[ any improvemmts authorizcd by thc City of Evcrett, in or of any strcet or allcy in �vhich thcy may have been]aid, qu City will nol bc require-d to furnish water during the progress of such imp:ovements to any consumer whose sup- ply may thus be cut ot[, ar be liable tor any damages for its failure so to do. Application No......�0.._7.�..y........ �t" �r CL !,:�./� , � /7 ' �,/ '!� / Block.........a............................Lo'.........,l...�" %Y .j f:..,.,_. .... Add...... ..c'.`�..........._..... ... No..........:�../_�i.� �--�c/ F��,�— ...........Strcc� ....................�r................r..................... . ....... ._.._......................................................................................_.............................._....................... Thc �vork to bc executed by.._.....................___._........__.................__..Plumber State sizc of tap. ................Tap to be insertcd in thc main. ...............Natcr doset ................B a t h ................Urin al ................Plain faucet inside .. .............Sidc walk washer ��.l. �.•.(�.=t/ ................Hosc 6ib outsidc '� � ._.............Hose bib for building Purposes i . � ................Hose bib inside �=l l/. �''.'' �:u.� � /(�_ ................Bib for stablc containing...................stall.................... ->.. /,J-/ __..._.......Number of persmis in family � � �� '� �r �.._.._....._Numbcr o: rooms in building ��« "�-�- �'"+ The premises are to be uscd as a.........................................._................._....._.... .... Thc owner of the premises is.............................._...._........................................____.. 'Phc aSent is.............................................._...__.........................................................._.. This applicatiai, although signed, sh�ll not be binding upon the City, until accepted by the Superiatende of the N ce�D artme t. � C jl / SiHned....�.�..1.-��....,l..[:�........'.......��...f.`_C.�l�Lc1�...�:...._Applicant / r Accepted...................................1......i�....... By..............:.................................................. I Superintendent.