2111 MCDOUGALL AVE A 2018-01-02 MF Import

ErrT� 3—b-1 i W. D. Form / 1500 0-1-17 C. P. CITY OF EVERETT—Water Department Application for Water All blanks nrus be filled in noncr/n/c.:e -I TO THE SUPERINTENDENT Of THE WATER DEPARTMENT, CITY OF E7ERETT: I hereby apply for the use of water in accordance with the rules and regula- tions of The Water Deparbn-_nt, for purposes and fixtures stated 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 IiaUlc for an)- damages t orys-L•tilure so to Jo. Application No... 4---- ______-ry-. Block._.____.___ .----- Lot ---- /__ ____________Add____ --------------- No ---- 2--�/1_ __________ __ ____ _____ ______Street ----The work to be executed by-__- ---- --------- __- Plumber State size of tap. __'h'__Tap to be inserted in the main. o t____ Water closet ---- Bath .Urinal ---------- Plain faucet inside ........... Side walk washzr ---------- Hose bib outside ----------- Hose bib for building purposes ---------- Hose bib inside -------- Bib for stable containing ------------ stall --- ------ ___ ___ Number of persons in family _ __ � ___Number of rooms in building The premises are to be used as a -------------------------------------- ------ Tire owner of the premises is ------------------ ____________________.____ Theagent is. ------------------ .----------- ------- .-___._____. ---____'-- This application, although signed, shall not be binding upon the City, until ac- cepted by The Superintendent of the Wnter )epnrtntent. Signed _q_-7- -. - - -- --_ ___._.__._.Applicant / Accepted_.3r__ / �-_________________________ Suaertntendent