3225 PINE ST 2018-01-02 MF Import

tV. D. Fo>_rm 4 1500 J-I-I) C. P. . ' CITY OF EVERETT==Water Department Application for Wafter All blanks must be filled in or crossed out q Everett__________ If(' G�/;.!._..!___. TO THE SUPERINTENDENT OF THE WATER DEPALTMENT, 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 fixtures stated below. During the time that any of the water mains may he taken up by reason of any improvements authorized by the City- of Everett, in or of any street ar alley in which they nosy 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.�2_.[ .7 Block ._._-_7 _____L --— /gty�-(' '--------.__.Add--— — — '----—- I\`o.._.�� _. _. ____ v _-_._'-__'___"._.__..Street _____________________ _________________________________________________________ The work to be executed by_________________________________________ Plumber State size of tap. �r __Tap to be inserted in the main. n ,-'f =- ---------- Water closet ---- ----- Bath '--'---- .urinal ---------- Plain faucet inside ------- p\yyI I i Side walk washer MAP --Per---- ___-___.._Bose bib outside __--- ti -________.hose bib for building purposest� _ ---------- Hose bib inside ---------- Bib for stable containing ------------ stall .......... ---------- Number of persons in family --- --- Number of roonos in building The premises are to be used as a __- _ ____ The owner of the premises is The agent is.. ----------------------------- This application, although signed, shall not be binding upon the City, until ac- cepted by The Superintendent o�fo the Wallb Department. Signed x__(�l_. _-[('�Erflu��tiY .y �---------- __Applicant Accepteda213Y'--