3428 HOYT AVE 2018-01-02 MF Import

=nY'JJ S-3 f9 W. D. Form ♦ 1500 0-1-17 C. P. CITY OF FvEnFi'' `,'at4r Deb ar?:��ent .Application for Water All blanks must be tilled in or crossed out Everett___ _____________ ___a�.�--_-__.-__191 .�-. TO THE SUPERINTENDENT OF THE WATER DEPARTMENT, CITY OF EVERETT: I hereby apply for the use of water in accordance with the rules and regula- tions of The Water Department, for purposes and bxmres stated below. During the time that any o' the water msics may be taken up by reason of any improvements authorized by the C`.y of Everett, in or of any street or alley in which they may have been laid, the City will not be required to furnish water during the progress of such improvements to any consumer whose supply may thus be cut off, or be liable for any damages for its failure so W do. Applicationo. o- "--- -i BlockZ----_-ft.__fp —/;- ------- -Add StreetNoLL .................... ....... . — ----------------------------- The ___________ __. work to be executed by_____._ __A...r-------- Plumber, State size of tap. _ ?r _-Tap to be inserted in the main. Water closet 5 •�'S_J ____Bath ^.S .Urinal --------- Plain faucet inside /��:r^^�.�\j •i'. \ \ --___-___Side walk washer -------- .-Hose bib outside ---------- Hose bib for building purposes ---------- Hose bib inside ---------- Bib for stable containing ------------ stall- ---------- Number of persons in family ---- /a -__Number of rooms in building The premises are to be used as a ---------------------- _---__-------- .--- . The owner of the premises is ------------------ ---------------------------- Theagent is ------------------------------ --------- .--------- ..____._-_-___ This application, although signed, shall not be binding upon the City, until @c- cepted by The Superintendent of t Wat apart nt. Signed.--- —_ --_- ---- --Applicant Accepted________________________________ `/� i /!/j Superintendnnt r