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09-18-96 04:52PM FRQM MU'f,1iT'EO V'ATEP, DIST, T�i 25ygg��g Ppfi?i�p3 <br /> , MUKI6TE0 WATER DISTRICT <br /> SNOHOMISH COUNTY WASHINGTON <br /> APPLICATION FOR WATEFi <br /> Application No. No. <br /> Meter Size �� <br /> Number ot Units �� Account No. <br /> I hereby apply tor water servioe and agree to be governed in accordance with the resalutions, rules and regulations or �he <br /> MUKILTEO WATER DISTRIGT pCRBilll�g t0 W81Bf SBNICB, now or 1lerealter In efleet. The untlersignetl as owner or <br /> representative of the here(n•deacribed pramisas hereby agreas as follows: <br /> (1� That Iho eost ef pny pxtonalon'el No waWr sorvieo,ronewal,roplacomant er pp�ir to roach and sonru Iho propery doscriDod xh+�V 60:,ome <br /> hy mywn or nstigne ac owner(s) ol me prem(ses. <br /> (2} That aN Oipaa,w�tw me�surinp daviaa�a�+d o�horeonracdnp puipm�nt upstrsam Irom tl+o moror:hall,akar u�eir ins�allauon,he and becomo <br /> thY praporry ol tla MIJKILTEO WATER OISTRICT, cubjxt W all h�ropulaEon�panaininp To waror wrviw. <br /> (3) That attor instaliutlon,if mororor mam�bo�andeppurooneae�ro 6uriad mdamagcd,tho owne�,will be hold rosponsible end ehergod lor aeme. <br /> (4) That the MLIKILTEO WATER OISYH�C7,ita offica�s end iQY�ti,ihill hiw M�e riyht ol inpross and epreSs lo po upon Ihe premises and properry <br /> dosaibod horoin ro�Wa purpoae of inspecGon,canrwatinp e�dicconnucGnp tlia servi�a fo�such othor purposea as the servico may requiry. <br /> It i��be unrentead dudnp Ih�tirn�Mol nny of dia vnMr nWn�m�y M out01 prrie�ky rwaon af uny em�ryonq or impravamonts Aulhorimd <br /> 6y tho DISTRICT,in any svoat or atlror bceYon in which thoy may haw 6aan Idd,d�e D13TRIC7 will not be requircd to lurnis�water durinp <br /> Na{frogre:�of cucA ImprovYmonn b any eonaumor whooa�upply may thuc 6y wt eB,or ho IiabW lor any damagss Iw iu faliure W do ca. <br /> (Sy That the DI3TRICT Mall haw Ihe rqht m ehanpa Iha nro�at any timo by Ratolutlen,m tanporarily diseandnua the aervica ro eeneumers,and <br /> m inataU iha meur(n) to repiawr Ne walor aonaumed. 7M DIStR1C7�huA not ha hald liebb fcr damapa 6y weter or othircauso rosulting(rom <br /> defecBve plumhinq u epplianae�InsWled by tha ownsrorxapanton tha premisee suppliedwith waror,andtho faa Ihat apents o!:he DISTRIC7 <br /> may havs Inapocmd the plumbinp end appliancea shall not be pbed es a basis Por recavery in casa of damspe ac aforasaid. if the supply ol <br /> weWr�hdl lail orbx inlonupt�d 6y ma�an olrcddu�l,IOW Pry{{JfY MOIhYf LiUiY WIWIbOUW��Um OIS7AICT aF�dl nut Oa held liubm lar damac�es <br /> na ahaA euch foilure or intorruptbn faany roesoneblr time he hold ro mna6tute a breach of oomracton�hs part of the OISTRICT or in any way <br /> ropeve tlfe mnsumer,w�e�har tenant or ownar,hom peMorminp Mo ohlipatlon ol such renanfs or ownar's contract. Weter shall be�sea hy <br /> apptieanl only on Iha promiwe daeaihad horoin. A naw epplieaGon slwq ha tilad rdwuld watar 6a dosirod fa olher oramisas althouph loca�ed <br /> on IIMd doaUibod AGIY(n. <br /> .�iN{'��Q,_(8) Th�t th� pISTRICT r�oomm�nd� in.�elleihn ef � pvn�un npWating vUve. Applla�n� acknewiedaas Infe�metlon as tc the <br /> r�commend��ion and�atuma�tulireapon�lhlll�y IorlMUlllnp orl�lllnp to Inatall e prasaure repulatinp velue nn�he water system to <br /> prebcl II from hlph prnsun. <br /> �pr�(,Z(7) The W8Tfi1CT uNllses eh�ek valvp �t th�m�tsr to pnvent w�br rolurninp lo th�Di�tdcts m�in�. Th� MSTRICT rroomm�nds <br /> InetUUtbnolrthwm��exp�n�lonUnktoptivenlexaeasiropra�urebuild•upau��dEytMwnxhaelsr. Appllunleaeknowledges <br /> Inlerm�tlen r�lo Ih�neommandAlon�nd�quma�full rwpoed►Ilty br In�bllinp e�(dllnp le In�1a11� 1h�rmal��p�neloe baR. <br /> sERVtcE ADCRESS: IO�IuT S',�G��_v_ �9.� LOT NO. ��� BLOCK �� <br /> �LAT NAME: n- � <br /> CITYBTATEIZIP: �J-!/G1I�. Lt�� 48aoS LEOALDESCRIP710N: f�.i''r0'F' Cf' �a ' <br /> _� ._ <br /> oWNEA'3 NAM�: t4Sh: Ow7 w✓ �nc.� � " �Gl,i r.�.ou.n"� <br /> OWNER'SAC10FiE3S: �A.ZI � �sa� P.QAtC. S� _. <br /> GITriSTA7E21p. ��h I�W o v e[�, (.0 A- ��03�7 ._ <br /> Tha premiseE Rn/W�h�a u�ad as a <br /> C�P /�'� liG �.I INFOIIN4ITION LETTER•OAVE/9ENTr ,� "( �% _ <br /> CHARGES: <br /> �Q�,yF(,� �/J/r 0 �)Senwa installaGon A oonnrciiwi dimpe / SDs�.�} r .07) <br /> r � <br /> S•cRy�tc Co•v�"••„+ (2�General Fadlitiec connectian d�arpe� '��0'p� <br /> G yA4G! � (3)Oehor �6a2 P- 0 0 �/D �.:l.y O t E�er�tl 1QOi 7�r-p <br /> 9/q�L � Toql�mount received wilh applicadon y �r.__¢7.�,s� <br /> /••.- <br /> IT I9 UND�R9TOop thei�his Appliw�iun,elthmgh aigned,Mall nol be 6inSng upm the•n'+"' """'NA7ER oISTRIC7 umil npproved by tho DI�TRiM <br /> I,tho undorafpnad,owner(a roprasnnwdw)o(tlie propehy debcribed AWve,do herehy mab�appliation lor inslalkUon ol a � �inch <br /> diamolor water�� p sorviee comoaion, incN,dirq ep0uran�neos,and dl neosssary labor at my axpantes. <br /> Oa�ad mis 1 _dey ot SS .lY �(�,,,,_,_ . <br /> APPLICANTS SIGNATURE: Y��_ � <br /> Rpplieacl'e Namo(ploaca Pnnq. T0.1h: O ea rv nn _ . <br /> Appi�ranfs Addross and Phono Number: �� � � �se�� /.Xa�c S� - -. � <br /> APPROVED: _L—rM wd� � ��' 9�G��"� 5EP 171996' <br /> M�:<�:.TEO�NA IS AICT <br /> MUNILTFO WqT�R 01SiHICT <br /> By. r . Di10: f <br />