3021 GRAND AVE 2018-01-02 MF Import

W. D. Fdfm t 1500 3-:-1 r C. P. CITY OF EVERETT—Water Department Application for Wat r All blanks nm- a filled in or cr se d out L Everett._.... ___ __./ .__ - _____.191 .- To THE SUPERINTENDENT OF THE WATER DEPA TNIENT, CITY OF E`lERETT: I hereby apply for the use of water in accordance with the rules and regula- tions of The Water Departm_nt, for purposes and fixtures stated below. During the time that ary of the water mains may be taken up by reason of any improvements at_thorized by the City 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 to do. Application No.__ &y__ 1 sf_` Block 2.__'�_- ..Street No..3_ �_ 2 �.. - •,Gift-fiJ Street ---- \ ------ r---------------------------- ---- The work to be executed by---- ----------------------------- Plumber State size of tap. _ _ �t.Tap to be inserted in the main. ___Water closet ---_ _� _ _-Bath CCC%%l _ _ _ .Urinal ___Plain faucet inside - UE• ---------- Side walk washer � "'N I ---------- Hose bib outside ---------- Hose bib for building purposes ---------- Hose bib inside MA-91 r ---------- Bib for stable containing ------------ stall- _Per- ---------- - to Number of persons in family /7---- Number of rooms in building r 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 ac. cepted by The Superintendenntt�offtt�hee Wat Department. Signed l L�_v=-="'� -/?----Applicant Accepted_._ ___.___. - }9�� B( 1 Supnrinlendant