1820 STATE ST 2018-01-02 MF Import

• 9.,..t:� �-r-1-�7-R1- �n�.i__.t 11- `1.1-_'� �rv� Form 4-1540—E. P.Co.-6-2631 City of- Everett --Water Department APPLICATION FOR WATER All blanks must be filled in or crossed out TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: CITY OF EVERETT: I hereby nl;Ply for the use of water in accordance with the rules and regu- lations of the Water Department, for pul Poses and fixtures stated below. During the time that any of the water mains may be taken up by reason Of any improvements authorised by the City of Everett, in or of any street or alley in which they cony have been laid, the City will not Jc required to furnish water during the Progress of such improvements to any consumer whose supply may thus be cut off, o be liab ty for any damages for its failure so to do. Application No .... ......._.3 ..h._ ......_. .. 7070 . Block......................._......__..... Lot............... Add............ No ...... L.. D...1'..i� _ _.. _.....1'�.`.-r!:.: `-�i........._ _....Street .. .... _... . _. ...................... . The work to be executed bq.lumber 4nta size of tap. 2'7 ..74tr....Tap to be inserted in the main. ................Water closet ................Bath �. ................ Urinal ...............Plain faucet inside ............ Side walk washer .............. 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 s Premises are to be used as a ..... ..... ...... (l h owner of the premises is...............1..l, 1 ,` Iagent is .......... ............................................. ......................................_........_.. ......... pplication, although signed, shall not be binding upon the City, until ,v the Superintendent of the Water Department. Signed ..... / � ��-- �� PPlicant erintendent