1904 STATE ST 2018-01-02 MF Import

W. D. Form 4 :505 3,1-1 ] C. F., - CITY OF EVERETT—Water Department Application for W�ter All blanks must be filled in or crossed nut y Everett. _ ____ ---------- Isi'___?-- TO THE SUPERINTENDIi'NI' OF THE 1VA' ' DEPART61ENT, CITY OF EVERETT: 1 hereby apply for the use of water in accordance with the odes and regula- tinns of The Water Deparunent, for purposes and fixtures stated below. During the time that airy 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 it, any consumer whose supply may thus be cut ff. or be liable for any damages for its failure so to do. to 6Application tion No .... ------- Block _____ __.Lnl .___-Add-- No --_-'l_9d _..!"C' Street ._.__.._____------- _------------ ____________________________________._.____ The work to be executed by______________ ------------------------ Plumber State.' eof tap. / o .__ r__'Y__Tap to be inserted in the main. Cj __-Water closet .__Bath -------- .Urinal ---------- Plain faucet inside ---------- Side walk washer ---------- Hose bib outside -I ---------- Hose bib far building purposes ---------- Hose bib inside/ ---------- Bib for stable containing ------------ stall.... .......... Number of persons in family --- _. _ _Number of rooms in building Th premises are to be used as a ---------------------------- _------- __ ______ The owner of the premises is ----------------- ________________ The agent is..___.____.._-.--------------- _________ This application, although signed, shall not be binding upon the City, until ac- cepted by The Superintendent of the Water Department. Signed_._. - ------------ Applicant Accepted. By _ ___ __________________..