2829 91ST ST SE 2018-01-02 MF Import

1 OFT.:, , z W. a. Form 4 CITY OF EVERETT-WATER DEPARTMENT A PPLICATION FOR WATER All blanks nuist be filled in or crossed out Everett,..... TO THE SUPERINTENDENT OF Tlit; WATER DEPARTMENT: CITY OF' EVERETT: I hereby apply for the use of water in accordance with the rules and regu. lations of the Water Department, for Purposes and fixtures stated below. During the time that any 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 to any consumer whose sup- ply may thus be cut off, or be liable for any damages for its failure so to do. Application Block.__ ....................)............ Lot Add..,..i%.....,.�,_<..,�7 ..................._.....__. _... The work to be executed by ... ....... ........_..._...__.... ............. _.. Plumber Slate size of lap. ..... Tap to be inserted in the main. ..............Water closet ................Bath ................Urinal ...............Plain faucet insider" ..........ti ......Side walk washer ..._.Hose bib outside "� ................Hose bib for building purposes ................Hose bib Inside .............. 9Ib for stable containing........... ....... stall.... ............. _.._IsTumber of persons in family _............ Number of rooms In building The premises are to be used as a..._.. The owner of the premL.es Is... . Theagent is... .. _.. _.. .......................................... This application, although signori, shall not be binding upon the City, until accepted by the Superintendent of the Water Department. Signed........._..........%�.:�•9....G�i�W ` .............Applicant Acccpled_... .19 ....... BY .... ... ........... ..... ......................... .................... Superintendent.