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<br /> � � � MUKILTEO WATER DISTRICT � �
<br /> _'� SNOHOMISHCOUNTYWASHINGTON ;• � I
<br /> • APPLICATION FOR WATER �� f` J
<br /> �application No. �L�/ No• / t� � 3�y
<br /> Number of units / Account No. L'�S y=19�7O�G� C
<br /> MeterSize �7�L^-�-- —� �
<br /> I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and reguiations of ihe i
<br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereaiter in etiect. The undersigned as owner or A
<br /> represe,�tative of the herein-described premises hereby agrees as tollows: �
<br /> .
<br /> (1) Ttiat tho cost of any extonsion of tho water sorvico,ranewal, repiacement or ropair to reach and servo tho properry dascribed shall bo borne �
<br /> by mysell or assigns as owner(s) of the prc..iises. C
<br /> (2) That all pipes,water measuriag devices and othor connoctlng oquipment upstroam from tha moter shall,aftor their insiallaGon,bo and hecoma �
<br /> the property ol tho MUKILTEO WATER DISTRICT, subjoct to ail its regulafions pertaining to water sorvice. ---' �
<br /> (3) That alrer installatian,if moter or meter box and appurtencas aro 6uried or damaged,the owner,will bo held responsible and charged far samo.
<br /> (1) That Ihe MU KILTEO WATER DISTRICT,its officors and agontc,shall havu ihe right of ingress and egress to go upon the pram�sos and pmpe ,ry
<br /> desuibed heroin for the purpose of inspecGon,connocting or dsconnuc5ng iho sorviw or lor such other purposes as Iho service may requiro.
<br /> It is also undersiood during ihe timo that any al tho water mains may be out ol service by reason ot any emergancy or impro4oments autharized
<br /> by the DISTRICT,in any stmet or other locafion in which they may havn boen Iaid,tha DISTRICT will not he mGuirad ro fumish water during
<br /> the progross ot such improvomrnts to any consumor whoso supply may thus be cut otf,or be liable lor any damagos for its failurc to do so.
<br /> (5) That tho DISTRICT shail havo tho right to chonga tho ralas at any time by Resolution,to tomporarily discontinuo tho survico to consumers,and
<br /> toinstalithemeter(s) toregistenhowaterconsumed. TheDISTRICTshalinotbeheldliablofardamagabywa�ororothercausemsul6ngtrom
<br /> dofectivn plumbing or appliances installed by tha ownar or oecupant on tho premises supplied with water,and Iha fact thatagents of the D ISTRICT
<br /> may havo inspectod tha plum6ing and appliances shall no[6e plaad as a basis lor mcovory in caso of dam�go as aforasaid. If th�supply of
<br /> wnter shall lai I or be intorrupted by reason ol accident,low pressure or other causo whatsoevor,tho DISTR�CT shall not bo held 1ia61e Ic�damages
<br /> nor shall such lailure or iNerruption tor any roasonable timo bo held to constitute a hreach of contract on the part ol the DISTRICT or in any way
<br /> � rnliow tho consumer,whothor tanant or ownor, Imm pedorming the ohligaoon of such tananYs or owner's contract. Water shall bo used 6y
<br /> applicant only on tho premisos doscri6ed herein. A new applicauon chall be filed should water be dusirod for other pramises allhough locatod
<br /> ��� ' on land descrihed herein.
<br /> �T _(6) That the DISTRICT reeommends Installailon of e preseure reguleting valva. Applicant acknowledgas Information ae to the
<br /> recommendntlon and ossumes full responsibillty(ar Installing or Iailing to Install a pressure regulating value on Iha weter system to
<br /> ,( protect It from high pressure.
<br /> ��t\ _(7) The DISTRICT utNfzes check vnlves at tho meter to provent waler rotumtng to Ihe Dfslricts malns. The DISTRICT recommends
<br /> '� ?-` i InstollaUonotathermalexpansiomm�ktopruventexceasivepressurehutld•upcuusedbythowaterheater. Appllcanisacknowledges
<br /> � � informatlon as to the recommendntion and assumos tull responsibl(ty for Installfng or talling to install a thermal expanalon tank.
<br /> SERVICE ADDRESS: _����.r:Ld� ��✓ LOT NO. / �' � ' BLOCK
<br /> PLAT NAME• _�����.`..�_�i
<br /> CITY/STATE/ZIP: r—•l�-� �r �/' r%�'}1�'!/ LEGALDESCRIPTION:
<br /> --Z�...ri�rT
<br /> OWNER'S NAME: _�� y�<�Ti.�rb��� I� ��u' f" .f� � Cv�. � � ,—� /'_'_T—
<br /> 06VNER'S ADDRESS: � � � �� �a�`-L y eb�
<br /> CITYISTATE/ZIP: €£��SLE,(�6� J ��� �.Fd� "'^ ��S':� -Z/.�3
<br /> .
<br /> Tho promisos aro to bo usod as a
<br /> � ��-� �c,� -� ���S.c.E�--- INFORAM1TION LETfER-GAVFJSENT:
<br /> CHARGES:
<br /> (1)Sarvico instatla6on 8 connection chargo S =��`n�
<br /> ✓
<br /> (2)Gennral Faciliuos connoction chargo 5 �7sr.E c�
<br /> (3)Othor 5 �
<br /> Tolal amount raoived with appliqGon 5 ��T�, E1eL
<br /> IT IS UNDERSTCOD that this Appliralion,aithough signod,shall not bo binding upon�ho MUKILTEO WATER DISTRICT untll approved 6y thn DISTRICT.
<br /> I,tho undersignod,ownor(or repmsanlative)ol tho proporty doscn6od ubovo,do heroby mako applicatlon for installation ol a _ % -inch
<br /> di�moror wator supply sorvico connecfion, including appurtonances,and aIl nocessary labor at my oxponsns. � {
<br /> Dated this � da�of �� ^ ,19 .
<br /> � � �
<br /> APPUCANTS SIGNATURE: � ��, �
<br /> �� ApplicanfsName(ploasop ' �i—T—tc ��� � �obc b"� ��� _� P�D
<br /> '`,,1pplicanYs Addrass and P Number:�C����d��i 2� ��� �, T �Ez AUG 311990
<br /> APPROVED:
<br /> MUKILTEO WATER DISTRICT MUKILTEO WATER DISiR
<br /> �Y� �� r,� Data: �/6
<br /> ���J �" � — � / ,
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