3707 ROCKEFELLER AVE 2018-01-02 MF Import

3 t W. 1). Form 4 ISoo 3-1-17 C. P. CITY OF EVERETT==Water Department Application for Water All blanks must be filled it. or crossed out Everett________________ ____y bo ---__ _._191 -_ ^. TO THE SUPERINTENDENT OF THE WATER DEPARTMENT, CITY OF E`JERETT: I hereby apply for the use of water in axordance with the rules and regula- tions of The lVater Dtpartment, for purposes and fixtures stated below. During the time that any of the water Ir:ains may be taken up by reason of any improvements authorized by the Citv of fivureR, in or of any street or alley in the City' will not be required to furnish water during which they ntay have been laid, the Progress of such improvements to any consumer whose supply may thus be cut off, or be liable for any damages for its failurr so to do. fo,6 2' ppplicntinGn No____ ______ Black _ / '2 3 11_._._._._Add____________________. No..-.__. _.''�-._/-U_�i C=?;`yY.. Street _ ____________________________________________ _________ Plumber The work to be executed by---------------- - _____________ State size of tap. _--_Tap In be inserted in the "lain. d� Water closet `� ) ---- Both .Urinal _-Plain faucet inside -- Side walk washer 1 Hose bib outside ol .......... Hose bib for building purposes JUN 0 - I ---______-Hose bib inside Per_,_ / j __________Bib for stable contannng------------ slat Number of persons in family �* r 6 --Number of rooms in building .The premises are N be used as a --------------------------- ----------- . The owner of the premises is _------------ I lie agent is. __________ --------------------------------- This application, although signed, shall not be binding upon the City, until ac- eeple" by The Superintende�"f Water D rtm t. -------- Applicant ng AccePted,!i�-r 19 ------------- Snoerintendem / v �`; f_ .