2112 73RD ST SE 2018-01-02 MF Import

W. a. Form 4 CITY OF EVERETT-WATER DEPARTMENT APPLICATION FOR WATER All blan6.:, must be filled in or crossed wit Everett,..__ TO THE, SUPERINTENDENT OF THE EE WATER DEPARTMENT: CITYI hereby apply for the use of water in accordance with the rules and regu- lations of the Water Department, for purposes and fixtures staled below. During the time that any of the water mains may bo taken up by reason of any Improvements authorized by the City of Everett, in or of any street or water during the progress of such Improvements to Sayconaumler whosefurnish up• ply may thus be cut off, or be liable for any damages for Its failure so to do. Application No.../.....s:-..:.-'.::'............. Block........................................ Lot............... ..........._........ Add......_ .... ..,..... .. _.......__....... "7 ......Blreel .........................:.... ..................................................................................................................... The work to be executed by... - -- - - - - -.Plumber Slate size of lap. ....T.�........Tap to be inserted In the main. r ................Water closet ' t ......Bath , f ✓�L F,try/It r. .......Urinal ................Plain frucet inside ................Side walk washer a .....Hose bib outside ._ .............Hose bib for building purposes ................Hose bib Inside ....I.._.I...__Dib for stable containing stall. _.... ....... _...Number of persons In family ,..-... ...... Number of rooms in building The premises are to be used as it The owner of the premises Is...._ .. The agent is ............... _. ..... . .......................... This application, allhough?lpned, shall not be binding upon the City, until accepted by the Su�perin�teppidA..-ecccnt of later parbnen ; Sign. { / r `� '_. _. .Applicant f Accepted..__..... .r/. .19 .. Bv.. ...._... ........ Superinlendenl. ._...._.......... �-