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, <br /> I PRV A¢BF.EM�N.T <br /> I <br /> i <br /> i <br /> i <br /> IThe underaianed hereby requesta the City oP Everett to wa ve <br /> iLhs PRV char�e on hie/her water aervice at <br /> , �� ����„n �_�_�s ��,�,K'i _ �J9 �_____,. The underalQned <br /> � represenLs Lhat Lha aervica at aaid location preaently has e PRV <br /> i <br /> iSn �ood workinQ order and that, in consideration of Waiver of <br /> � <br /> Iaaid charQe, Por the period Lhat undersianed is a water servi ce <br /> cuatomer at the above location, the undersigned agrees: <br /> 1 . To maintain said PRV in good working order; and <br /> 2 liabilitY arisingCfrom 1nc easedtoperatingaPressures8on <br /> the ri5 transmisaion line to Which the above Water <br /> service is connected; and <br /> � 3. To indemnify and hold harmless the CitY of Everett from <br /> i <br /> +, anY and all claims related to the failure of the P <br /> i installed at the above location. Thia indemnity is on <br /> � behal4 of tha undersiBned, and the undersiBned aerees <br /> to notiYy the city of Everett oP any change of <br /> I ownership of the water aervice connection at the above <br /> Ilocation. <br /> '! DATED this __1_!�►d8Y of J c , 1987. <br /> � <br /> STATS OF WASHINGTON) <br /> ss� <br /> COUNTY OF �� <br /> I certify that 1 know or have satisfactory evlden�e <br /> that __��^�I�� � �n � - signed this <br /> � inatrument and acknowledBed it co be (his, her, their) :ree <br /> i <br /> and voluntary act for the uses and purposea mention in the <br /> �j instrument. <br /> IDated: -� —�---��'�----- <br /> I (Seal or StamP( Signature of ��,_�rti �.e�3cu <br /> 'I Notary Public: <br /> ITitle� � �M"tQ�'�"- <br /> � My commisaion expirea� __��-- <br />