Laserfiche WebLink
- ��.- of� '! � ' ��� MUKILTEO WATER 1DISTRICT � � <br /> SNOHOMISH COUNTY WASHINGTON O � <br /> 1 - �'7 — / ',' (?� <br /> ' ' - ��'.' / ` �.` APPLICATION FOR WATER " � � <br /> �'"�i / <br /> r�pplication No. ( No. �: <br /> Meter Size 3�U r n� �� Number of Units Account No. D-? �' a `7 /S�n r�U L � <br /> I hereby apply for water service and agree to be governed in accordance with ihe resolutions, rules and regulations of the ( <br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereafier in effect. The undersigned as owner or r <br /> representative of the herein•described premises hereby agrees as loliows: � <br /> (1) That the cost ot any oxtension of Uio waror sorvice,renewal,replacoment or repair to reach and serve tho property described shall ta bome <br /> by myself or assigns as o�vner(s) of the premises. <br /> (2) That all pipes,water measurirg doviaas and other connocting oquipment upstream from the meter shall,aftor their Installation,6��and b=come <br /> the property of the MUKILTEO WATER DISTFICT,suhjea to all its regulations partaining to watar sarvico. <br /> (3) That altor installation,if ineter or melor box and appurtonces are buried or damagod,the owner,will be hold responsiblo and ch,,�5ed lor;amo. <br /> (4) That tho MUKILTEO WATER DISTRICT,its oifcers and agonts,shall havo tho right ol ingross and egress to go upon the premis�•and properry <br /> described heroin for tho purposo ot inspecGon,connocting or disconnoc6ng Iho sorvico or for sucF other purposes as tho servic:may requira. <br /> It is also understood during tho tima that any at tho water mains may be out ol servica by reason of any omergency or improvements authorized <br /> hy Iho DISI-RICT,in any street or other location in which they may havo been laid,the DISTRICT will nat 6e reGuired:o.fumisl�water during <br /> tho progress of such impmvements to any consumer whose supply may thus bo wt off,or be liahle br any damages tor its iailure to do so. <br /> (5) That iho DISTRICT shall havo tho right to changa the ralos at any time by Rosolution,to temporarily discontinue tho sarvico lo consumors,and <br /> toinstallthomoter(s) toregistor�hawaterconsumed. TheDISTRICTshallnotboheldliablofordamagobywamrorotherwusc rosultingfrom <br /> dofective plumbing or applianxs installed by tho ownor or occupant un tha promises suppliod with wator,and tho fact that agents of the DISTI?ICT <br /> may havo inspected the plumbing nnd appliances sholl not bo plead as a basis lor rocovary in caso of damage as aforasaid. If the supaly of <br /> wnter shall lail or be interrupted by reason of acddent,low pressura or other causo whatsouvar,the DISTRICT shull not ho held liab!o for damages <br /> nor shall such faiWre or interruption tor nny raasonable fimo ba held lo constimle a breach ol contrect on the part ot tho DISTRIC f"or in any way . <br /> rolieva thn consumor,whother ten�nt or ownar,fmm poAorminy�e o6ligation ol such tenanCs or ownoPs conlract. Water shali 6o used.hy. �� <br /> � applicant only on tho premises doscribod horoin. A now applicaGon shali bo lilod should wator be desirod for ather premisus although localed <br /> on land desaihed herein. <br /> iNr�(6) Thm ihe DISTRICT recommends Installallon of a`pressura regulnting valve. Applleant acknowledges Inlormetlon os to the <br /> ✓ recommendotlon and assumes lull responsiblllty lar installing or lailing�o install a pressure regulating valuc on ihe wuier system ta <br /> ,�/� protect It from high pressura �-r� <br /> inT_//// (7) The DISTRICT utilizes check valves al tha mefer to pravnal wuler reWming to �he Dlsidcts malns. The DISTRICT recommenda - <br /> Instnllotlonotathermolezpanslontankloprevenlexcesalveptessurehulld-upeausedbytheweterhenter. Appllcanlsacknowiedgea <br /> ����' Inlormoqon ns l0 1he rocommondetian and assumes-NII responslhilry for Instellfng or lalting lo Instell a thermai expnnsion tank. <br /> SERVICE ADDRESS: 39�� COx'bi1 DL'iVe LOT NO. �' BLOCK —' <br /> . ' �:�PLAT NAME: �'�'f"`�C.I�'i ��Cl�'�T 1"� <br /> CITY/STATE/ZIP: "^ r rt�L QQ�n� _,LEGAL DESCRIPTION:����_I�I� I�1� �C._. _ <br /> owNER's NAME: Tim Williamson/Lee ldaodard - �e � �r -�-�� "I.-�- Y�jr�.'�c^ic � .- c�-i���r-��" <br /> n ' .L ^� ' <br /> OWNEF'S ADDFiE55 ���h rf°Jr � •^ �� �� � ` '�c <br /> CI1Y15TATBZIP: �Verett W:1.98201 ��'i i r'�� rY �` ���'N� ��.�_ �j"� i � '�i i f� <br /> Tha promisas aro to 6o usod as a �esid��ti�l Home � J��'� � � <br /> �+ ��( I-+ �i/11 I I U INFORMATION LET7EF-GAVElSENT: � =L. <br /> �---�— .,�.c.C c <br /> . CHARGES: <br /> (1)Servico installauon&cennection chargo s _ `�yS� �'� :'i � C. <br /> (2)Ganeral Fndlities connaction chargo S ��5' ��'%'— <br /> (3)Olher S — <br /> TaWI amount recoived with appliwtian S �����' � J <br /> IT IS UNDERSTOOD thai this Application,although signed,shall not 6o binding upon tha MUKILTEO 1YATER DISTRICT until approved by tho DISTRICT. <br /> i,the undorsignod,owner(or represontaGvo)ol tho prbpert�doscnbed alvve,do herehy make applicauon Icr insialla6on of a ��U -inch <br /> diamoter wator supply sorvico connaction;including appurtonances�liliocossary labor at my expenses. - � �" <br /> Dated this 4 dny of �•i/ny �. .%l t�- 89 . _ n , � ' <br /> �� � � <br /> _�/L-�� � ...,/! !i%�!��r-`—^�=. . r�. <br /> FPPUCANTS SIGNATURE: � - - - � <br /> - 1pplicanYs Nama (ploaso prinq: Ti m 1�H 11 i.�mann�T.n� !Jnndard ' _ � n,�i� <br /> - i-t11 <br /> ��Applicanfs Address and Phono Numhor: '�anf, a�}_�p�•�t •d� �A7n1 <br /> APPROVED: ^5a_�54------�'-�---Ga�n�� MAY 3' �� <br /> MUKILTEO WATER DISTRICT <br /> � " / . pAW(ILTEA WATER DISiRIC <br /> gy. i//'�� Ni,•�.--�------ Da�e: .. <br /> 7J-�� � <br />