3501 ROCKEFELLER AVE 2018-01-02 MF Import

CI W. D. Form 4 1500 3-1-17 C. P. CITY OF EVERETT==Water Department Application for Water All blanks must be filled in or crnsse out Everett_____________}ncn_ ..y/.__________19iY4K TO THE SUPERINTL'NDE.NT OF THE WATER DEPARTMENT. CITY OF E`iERETT: 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 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 r,ny thus be cut off, or be liable for any damages for its failure so to do. Application No..__,[_ Y Block .------ A-` ...... Lot --- /- </�- - -✓ Add ----_-...._. w........•.. Stre't _._.. _____________ _ __________ _____...__..__._-_____________.___-__.______ The work to be executed by ------- ..___LV __________• Plumber Smte. ze of tap. -Tap to be inserted in the main. r -------- Water closet�S^V- ---_ ----Bath ' ------- .Urinal ----- ----Plain faucet inside —.___Side walk washer _ _ . _ Hose bib outside / _.Hose bib for building purposes _ _ _ _ Hose bib inside ___- _____ Bib for stable containing --- ---._--stall__ _____ _._ 1p�__Number of persons is family . ___Number of rooms in building'`_ The Premises ore to be used as a___..YT- ---------------------- The owner of the premises is __=1. t_tq,�LVA" _�,_/.__--_______-_-..____ The agent is _ . _ This application, .Ithough signed, shall not be binding upon the City, until ao cepted by The Superintendent of the Water Department. Signed _�:__��_��,1, ___ .___ _____ p icant �r Acccpted�J.� �__nlMelr By____ _ 7__jenaen