214 MADISON ST 2016-01-01 MF Import

l/ _ W. D. Farm 4 �=, � �� CITY OF EVERETT-�Y'✓ATER DEPARTMENT APPLICATIOI� F4I� WATER All blanks must be filled in or crossed out Everett ............................_ �.c4_tL.'r-?:..?�...................191s�/" TO TFiIs SUYliRINTENDENT OF THE WATEA DEPARTMENT: CITY OF EVERETT: I hereby apply tor the use of water in accorda�ce with lhe rules and ragu- lations ot the Water Department, for purposes ana fixtures stated below. During the limc that any of the water mains may be taken up by reason ot any improvements authorized by thc City nf Everett. in or of any street or aiiey in which they mny hace been ]aid, the Ci�y will not be required to furnish w:�ter during the progress of such improvements to any consumer �vhose sup- ply may thus be cut off, or be liable for any damages for its failure so to do. Application No........�.� �../.��............ Block._ ..................................... Lot.............. �.................... Add......� �, �:.r,��_.� ✓i.� — � . No............ �. �.5�....�%:r.�,�f>zr:, ............................................. ...........Strect ..... ................................................................................................................................................. The woru to Ue executed by ............._............._..................._........_........_Plumbcr Staj�izc oL tap. %�/_.Tap to be inserted in the main. ...............Watcr closet �� /JzG�i�� �� // .......✓..._... Bath ..... ..........Urinal ................Plain faucet inside ........._.....Sidc walk waslier ��ctt� �. ................Hosc bib oulsidc �y� S� i� L� ............_..Hosc Uib for building purposes Y '� � y� 7 ................Hosc bib inside � . Q., � ....,,�r��/' `L"J c.- c:.. ..._...........Bib for stablc containing.........__....p�t�I1.....:..1.......;. _.� � :.. ; ^ .. .. ...............Numbcr of persons in family '-'�. �.- �Y' .... .t�.�........NumUcr of ruoms in building ._�� 7'he Premises are to bc used as a ....................................._......................._......_.... ... The owner of the Premises is....._...._...._..._._ ..............................................._..._._.... TSeagent is ................................................................._..............._............................_.... 1'his application, althou� -iFned, sl 11 not be binding upon the City, u�itil accepted by the Superin f t nf the Ler Dep�rtment. . Siened...�...!��.�d`.� ..............�P.�.�.._� .� .J.......__............................Applicant Accc�ted ........................ ..._............1Q....... By............................._......... . ........................... BuPcrin:endent.