9512 24TH AVE SE 2016-01-01 MF Import

r � . � --u.,_�__._._._._.-- — � - �i� . W.D. Fotm 4 � , CITY OF EVERETT-WATEP. DEPARTMENT ( APPLICATION �'JR WAT'ER All blanks must he filled in or crossed out I . •�.:-.<:�:...�"..,.-i....._..... .._..._ v EVerett..................... .. . 19�..... �_. .✓ . TO THE SUPERINTENDENT OF THE WATER DEPAHTMENT: CITI OF EVERETT: I hereby apply for lhe use of water in accordance with tt�e rules and regu- latinns of the Wat : Department, for Purposes and fixtures stated below. During the tin e that any ot the watcr mains may bc taken up by rcason of any improvements aulhorized Uy thc City of Everett, in or of any street or alley in �ahich they mny have been laid, lhe City will not be req �i*ed to turnish waler during the progress of such improvements to any consumer whose sup- pty may thus be cut off, or be ]iable tor any damages for its failure so to do. /i Jy.>- . Application No.�..�................................. ................. Add;::-Y�-:`._`�=`_'`_ Block........................................Lot................"...... . . _..._.......... �J No............�.�..;:'.-l�.r.....,f'��[�.....................................................Strect ...................................................................................................................................................... � The work to be executed by... ......................._._...._........._. ..._....._...._.Plumber State.sizc of tap. _�f!...,Ta� to be inserted in the main. ................Watcr closet . �' ;.�*K..i ................Bath �,"r /, p .n� ' Urinal �� " fj . %� ,� '�r � ................Plain faucet inside �)'�� i i .'. > ,/ '3' �r ................Si;lc walk washer � � :.�,�'�/J�i ,�r/ - r �t' _....._.......I�iose bib outsidc :��- , � r�' r"' . , , . �, � f �" .._............Hosc bib fo: bmlding purpoSes��; ' � .., r F, " �,- _ ; >> ................FIose bib inside -� ..__..........Bib for stable containing....................stall........._......... � ...............Nambcr of persons in familp .___.........ATumber o. rooms in hnilding The Premises are to bc used as a......._______...............__.......____._.... ..._._........ The owner of thc pmmisea is....... ._......____......._...._._..._.......................__....__..... Theasent is..._...............................__.. _._.............._.._..._..._......_......_......._........_.... This applir.dion, althou^h signed, shal] not Uc binding upon the City, until ,iceepted Ly the Superiq��endent nf tlie �Vater Department. Si�nedl'....yG.�J�'`Y..?!!�:�...GJ�„i;'�y._`.�_........._...........ApPlicant ! J Arcrpted._ . . . _.._ _._...19._.... By_ . . ......._.._ . . . ...... .. ._._....... �uperintmdent.