810 PECKS DR 2016-01-01 MF Import

W.D. Form 4 , ' ' ` `- `- �� CITY OF EVERETT-WATER DEPARTMENT APPLICATION FOR WATER All blanks musl be filled in or crossed oul Evcrelt�............................_......_ �� - 1 TO TffE SUPERINI'ENDENT OF THE WATER DEPARTDqENT: '� CITY OF EVEFETT: I hereby apply tor the use o(n�ater in accordanee with the rules and regu- lations o[ the Water Department, tor purposes and tixtures slated below. During thc Limc lhat any of the water mains may bc taken up bp reason ot any improvements authoriud by the City of Ever.tt, in or of any street or ,:llep in ��hich thcy may havr. been ]aid, the City will not be required to turnish �cater during the progress ot such improvements to any consumer �s�hose sup- ply may thus be cut oft, or bc liable for any damages for its tailure so to do. �PPlicalion No...........��..%..7� ..... Hlor.k...................._....._.........._ LoL..............�L-/ i�( � .` ' , .............. Add................. .. � ' . � . .._._._.._. .._. No.._.............�..L..C::.....C......f:L...2:.._......,.,....t.'s:�.%,_[.1.r.:............Strect ................................................................................ . ......... Thc work to be executed by_. ............. . .__..................................____.. .. Plmnbez State size of tap. � � ��............Tap to bc inscrted in the mnin. �''_I � � ��.�...........Watcr doset '� i ................Bath " 5 "� . .��r ................Urinal ��R22 65 r,;., ��4 c 7 c . - --.._...._...p]ain faucct insidc - ��.r� . ................Side a�alk washcr ��'�'`�� 'c�-' i.: . `� � i C• �. ` �chT � --��.-.......Hose bib outside ; � --��........Hose bib tor building purposes " - � ...............Aose bib insidc .>,�{ C�/�-, .l�-ti �. ................Hib tor staUle conlaining..............._..stell.................... / • ��......_.._P7umbcr of persons in tamily __�--...._...A'umbcr of rooms in building � '-' � ' (C - �� -,�,—<� �u� C_(I,U'„_ The premises are to be used as a............................ t�.:./L�...-�c::,i..,.�-.:l.d.- The owner ot the premises is......__... ._..___..........__........_....... . • . ............�! TSc aGent is................._._.... i . -��C.. . . . .. ._____..__._....._...:.�:.},*.-�.c.:..�L.L"!,'... �:.�. . ,�....... �s app]ication, alt}��h signed, shall nat bc binding upon the City, until accepted b}• the Superintendent ot the R'ater partment. T 7 Signtd._�� y ......_...............��.�w.C�� _APPlicant ......_....... . Aceep:ed..._ . . . . . .. .._.............._.......IP....... By..................................... _..._ . _ ............... S��P��mtcndcnt.