2018 MONROE AVE 2016-01-01 MF Import

- . ,�,i..� c� , W.D. Fo�m 4 CITY OF EVERETT—WATER DEPARThIENT APPLICATION FOR WATER All blanks musl be filled in or cr�ssed out S� c-:, �_� _ ' ' E��««......................................................f........_......_......is N.Y. TO TFIE SUPERINTENDEIQT OF THE WATER DEPARTMENT: CITY OA' EVERETT: I hereby apply for thc usc of water in accordance with the rules and regu- lations of the \Vater Departme:it, for purposes and fixtures stated Uelow. During the timc lhat any of the water mains may be tnken up Uy reason of any improvemenis authorized Uy the City of Everelt, in or of any street or alley in which lhey may have Ucen laid, thc City �rill not be required to furtush - wat^r during lhe progress ot such improvements to any consumer �vhose sup- ply may thus be cut o[t, or bc liable for an}- damages for ils failure so to do. APPlication No...,/..c/-..'�'i'.<•................ Block.............r..-,5'._............._Lot......../`�-�...��....... Addd:.!a(2.>'.s`u.<�7....Jr �> > .�- .-........Street No......�.�(1�..........2:.,.:f:.zE:'-:F:�.—...................................... ...................................................................................................................................................... The work �o be esecuted by........_......................._......_...............__........Plumber � Sta1c izc of tap. ...�.�...Tap lo be inscrted in thc main. ................Naier closet � � �.�........Bath ..'�. ....Urinal Q, % `� ' ��1 „� � ._ . "- ............. Plain faucel insida r�V25 ic ."'j��:, _. ...............Side walk washcr U� ��+Y cf . �� , ;-Jcl ..........Hose Uib outsidc b'�i�rl Cv�rctt `'• +,, ................Hose bib for building purposes ��EpT, e ��' ................}I�sc bib insidc ................Bib for slablc conlaining...................slall.._........._..... ...._......_.Numbcr o[ persons in family __.=t.. ._Numh�r ot rooms in building The premiscs are to be used as a............................._....__.._.__. .. _..._. ____..___. Thc owner of lhe Premises is......_......._____..........._...................__...._..._ ........__.. TScagent is......................_......_.._.. ...._.._... ...........................__._......_....__..........._. This application, althouph signed, c�� not Ue binding upon the CitY. until accepted by the Supe�r,�i tendent o[ the Wate/r� D/ epartment. SiSnede�.c`.l'�:��..CS.—....�.�C..'..�.J..:'.c5.1.1:J+.4,'C'.._...._....._........APplicant Accepted.........__..............................1�....... Sy......_..............._...................._........_........... Superintendent.