2316 E GRAND AVE 2016-01-01 MF Import

. ,� i i W.D. Fo�m 4 � C/ /� �' CITY OF EVERETT-WATER DEPARTMENT APPLICATIaN FOR WATER All blanks tnust be filled in or crossed out � Everett.......................��:`......�._�.....................................19�::.....✓. TO T!{E SUPERINTENDENT OF THE \VATER DEPARTMENT: CITY OF EVERETT: I hereby apply for the use o[water in accordance with the rules and regu- lations ot the Waler Department, for purposes and fixlures siated below. During thc timc that any of the waler mains may bc taken up Uy rcason of any improvements authorized by tne Cily of Everett, in or of any sVeet or alley in which they may have bcen laid, lhe City will not be required to furnish water during the progress ot such improvements to any consumer whose sup- ply may thus Ue cut oft, or be liable for any damages tor its failure so to do. . , Application No. ....(,.::..1..::�................ sio�k.......`�...,1.._C:..................r.oc....�.'...5...'�_�'_J......... naa............_,.............._........... No....._........._.......... ....:�...j.�..L........... �..._.......::;'z..6Ca.::.<..�.Slrccl ...................................................................................................................................................... The work to be executed bY...--......................_...... ............................_Plumbcr Stalc size of lsp. �J. �..._Tap to be inserted in lhe tnain. y,.. ................�vatcr dosct ......�._....IIath / L.,. . ��;-ci" ._�. , , . �.; ................ilrinal .........._....Plain taucet inside f � � . .. . �,.�c,s ; �� i� . ................Side walk washcr . . . ................Hosc Uib outsidc ................Hose bib tor building purposes � . � . ` � � ' i.�r ;. � ................Hosc bib inside � � fE�/10 tS �a y -� ; .� ...._...�..�IIib tor stable containinti....................stnll......... , � r{'�u'��{`EN6'6� ._.....�.t...Numbcr of persons in family ��,..��a .,��;� / i„ i ....�.Numbcr of r�oms in building '�c k .. , •� „ Thc Premises arc to Uc used as n_ ........................_................................._................ The owner of the premises is..........._......................._.................._...._........._......_... Thea�ent is..................__..........__..............................._......._........................................ This application, althou�±h signed, shall not Uc binding upon the Cily, until accepted by the Superintendent of lhq \5'atcr Depardnent. Signed':....�._.:::.:.'::�:::....,:..:�.i,.:..:...._c�� „ .�_q.:...:...:�::..:.Applicant _.._...,..... / Accepled....._.....__...................._....1�....... By..............................................................._... Superintendenl.