2125 MCDOUGALL AVE 2018-01-02 MF Import

V'. D. Fotm � I500 a-1-17 C. P. CITY OF EVERETT==Water Department Application for Water All blanks must be filled in or crossed out �/fJ Everett,. --------------- ---------191 %--- TO TIIE SUPERINTENDENT OF THE WATER DEPARTMENT, CITY OF E`JERETT: I hereby apply for the use of water in accordance with the rules and regula- tions of The Water Department, for purposes and fixtures slated below. During the time that ;my 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 dama es for its failure so to do. Application No!!_,,_ _---------- ,,// f' ' Block .___7-�rf� --- Lot__'(/�LTt.-�--�-_,77�'-}} Add_'//"-"-4""-"___ No ---- --P-u Street ----------- _--------- _------------------------------------ ____--------._____ The work to be executed by -_--------- ---- ---------------------- - Plumber Stale size of tap. j U (/ rip to be inserted in the main. Q xx ______ _Water closet ------ /--Bath _---.__- .Urinal f . ---------- Plain faucet inside i Side walk washer ^y,{ ----------Ilose bib outsidee v ------ .--- Hose bib for building purposes _Hose bib inside �` w_ -------- Bib for stable containing ------------ stall --_-_cr_,.t s . _ _ _ . _ . _ _: Nmnber of persons in family ____.5___Numbcr of rooms in building The premises are to be used as a ______________________________________ ------ The owner of the premises is --------------- _________________________________ Theagent is. --- -.-------------- ------- .----------------- ___-___ This application, although signed, shall nut be binding upon the City, until ac- cepted by The Superimenden of the Water De arunent. Signed_-________'__._ __ ___________Applicant Accepted _/ __ 1�Z By ��--- /_---------_____________ - --- Sunamm�dent