3205 NASSAU ST 2018-01-02 MF Import

W. D. Form 4 1500 0-1-17 C. F. �• CITY OF EVERETTe Water Department Aplpiication for Water All blanks no t be filled in or erossrd out Everett__ __----------------------- .----- .---- 191 TO THE SUPERINTENDENT OF THV WATER DEPARTMENT, CITY Ol• EVERETT: 1 hereby apply for the use of water in accordance with the rules and regula. tions of'rhe Water Department, for purposes and fixtures staled below. During the time that any of the water mains may be taken up by reason of any improvements authorized 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 Block ____ _ �-l'-----L°t--- No.. _Z_o_ 7-'Ou!t•�----Street __._.__.--______ _ ___________ 'fhe work to be exc�u[ed by____________________________________ _____ Plumber State size of tap. ;& _Tap to be inserted in the main. /--- Water closet .__._/- __-Rath 11-------- -Urinal O OG ---------- Plain faucet inside O ---- ---------- Side walk washer C7 U L r 7 t� ---------- Hose bib outside Y,>, h ___Hose bib for building purpos (o 1 ---------- Hose bib inside _-__- CJ f ,1 ___Rib for stable containing.__ 1)_f __`T' Number of persons in fa ill ` pQ� �• to f Number of rooms in buildingL j The premises are to be used as a --------- - ..... The owner of the premises is 1 Theagent is ------------------------------- _______-_.._-__-._-_- This application, although signed, shalt not be binding upon the City, until ac. cepted by The Superintendent of the ter Departmept. Signed _ __ ____ _ _____T._ ... Applicant e t Atcepto— /�-----191� By - - / SuPorinlendenl