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<br /> . �.~ ^I� �r MUKILTEO WATER DISTRICT ��a � � � �
<br /> � � SNOHOMISH COUNTY WASHINGTON �
<br /> APPLICATION FOR WATER �
<br /> r I
<br /> Application No. '� No. �
<br /> Meter Size 3�a �� Number oi Units � Account No. n�s - ���o� DOd �
<br /> I hereby apply forwater service and agree to be governed in accordance with the resoiutions, rules and regulations oi the o�
<br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in eifect. The undersigned as owner or C
<br /> represernative ol the herein-described premises hereby agrees as lollows: C
<br /> (t) That the eosi ot any oztension of tho water sorvice,renowal, replacoment or repair to roach and serve tho property doscribed shall be bome �
<br /> by rnysall or assigns as owner(s) of thc�;emisos.
<br /> (2) Tha:allpipes,watermoasuringdovixs:.ndothorconnoctingequipmentupstroamhomthemetarshall,ahorthoirinsWilation,beandbecomo
<br /> the properry of the MUKILTEO WAThH DISTRICT, subjad to nll its regulaGons ponaining to water sorvice. -
<br /> (�) That altor instaltation,if molor or metor boz nnd appurtencos are bunud or dainagad,the owner,will be held responsiblo and chargod for same.
<br /> (4) ThattheMUKILTEOWATERDISTRICT,itsotficorsandagonts,shallhavethorightofingrassandegrosstogouponthopremisesandprope ,ry
<br /> desuibod herein for tho purpose of inspoction,connecting or disconnecGng tha sorvice or for such oth�r purposos as tha service may roquire.
<br /> It is also undcrstood during tho timo that any of tho water mains may be out of servica by reason of any emorgoncy or impmvements authorized
<br /> by iho DISTRICT,in any street or other location in which they may bavo been faid,-tho D�STRICT will not be roquired to fumish water durinfl
<br /> the progross af such improvaments to any consumer whose supply mey thus 6e eut ott,or bo liahlo for any damages for ils failuro to d. so.
<br /> (5) That tho DISTRICT shall havo tho right lo chango the ralos at any timo by Rosolution,to tompornrily diseonGnuo Ltio sarvica to consumers,and
<br /> to ins WII the meter(s) to registor tho wntar consumed. The DISTRICT shall not be hold liablo for damago by wator or oeher wuse rasulting from
<br /> � dotecuveplumhingorappliancesinsWlledbythoownororoccupantonlhepremisessuppliedwithwater,nndtholaclthatayantsofihoDISTRICT
<br /> may havo inspectod tho plumbing and appliancos shall not be pload as u hasis for rocovory in wse al damago as aforesaid. It Ihe supply of
<br /> wuter sh�ll lail or be intortupled by reason ol accident,low pressuro orothor eauso whatsoevar,tha DISTRICT shall not ba held liabio tor damages
<br /> nor shall such lailure or interruption lor any raasonable time be held lo constituto a broach of contraat on the pan ol the DISTRICT or in any way
<br /> �^ ^ mlievo Iho consumor,whothor tenanl or ownor,hom pedorming iho obligation of such tonant's or owner's conVact. Wntor shall bo usod hy
<br /> /�/ ap�l�canl only on the promisos desaibod harein. A new appliwuon shail bo filed should wator bo desimd lor ather promisos elthough�ocatod
<br /> ,� � I y on land dosuibed horain. -
<br /> INT ��) Thnt tho DISTRICT reeommends Installatlon ol a pressure regulating velve. Applieenl acknowledges Informetlon es to Ihe
<br /> � � � � recommendoUon nnd assumes full responslblllry lor Installing or fellfng to Instell a pressure regutaling velue on the weter system to
<br /> �/ f�% proteet II Irom hlgh pressure. �
<br /> INT�_L-_..(7) Tho DISTRICT utilizus aheck valves at the meter ta prevent walor returning to the Olslriets melns. The DISTHICT recommands
<br /> r • Installatlonolathermalexpenslonlanklopreventexeesslvepressurebulld-upeausedbylhewalerheater. Appllcantsacknowledges
<br /> _ � Inlormellon ns to Iha rceammendotlan and essumes lull responclbllty tor Installing or felling to Inslell a lhermel�expanslon�ank.
<br /> SERVICE ADDRESS: q b�� �i��..�_ ,J n LOT NO. �i � � �.Cr � �-I (1 £ 1 BLOCK
<br /> } PLAT NAME: 'n'�e,.r.,1 v `1t.n��._... �w � I
<br /> CITY/STATE/ZIP: C� .r.,. l� l �l- LEGAL DESCqIPTION:
<br /> OWNER'S NAA1E: �1f..�a r� �L . r�w_c �
<br /> � 01NNER'S ADDRESS: "1�1 11 - 1'1�,LL L, �� .
<br /> CITY/STATE/ZIP: ��,uv�e,�.,&� �.��.._ �i�U Z U /
<br /> - ,Tho promises aro to bo usod as a ...�.�--_ cr�_—�,fi•���� , l�'
<br /> (� V
<br /> -�_��'ti�G-CS'i�T—�l:..l�.�� I � � INr'ORMATION LETTER-GAVE/SENT: C '� J
<br /> CHARGES:
<br /> �
<br /> (7)Servico installation S connection chargo S '11
<br /> . (2)Genarai Fadlioos connuc6on chargo $ +�-�b•O O
<br /> (3)Other �5
<br /> Total amount received with appliq0on S ���J� U(.�
<br /> IT IS UNDEFS700D thm this Appliwtion,although signad,shull not bo 6indng upon the MUKILTEO WATER DISTRICTuntil approvod by the DISTRICT.
<br /> �.
<br /> I, t!s undersignod,ownor(or represenWtivo)oi tho propony dascribed ubovo,do horoby make nppliwtion lor inslallaUon of a •inch
<br /> diameter watar su ply sarvico cannee6on^induding appurtonancGs,and ill nowssary labor at my oxponsos.
<br /> Dated this •S-\ pay ot J_41,. , , � :�. � .ts �C ,�_ .
<br /> ,•/`;l C �f
<br /> APPLICANTS SIGNATURE: ^� � '
<br /> \pplicanCs Namo(plaaso print;� — •� ' ��� �:�,` � . .�^ (� n` P
<br /> �'--Appli;anfs Address and Phof�o Numbar: ,' —�" �� �� I ', S W �-��,`.� '-� C y PAID
<br /> APPROVED• -� (-- r ,„ ,.. !�s : �A �� goz o � FEB 0 81990
<br /> MUKILT ATER DISTRICT .
<br /> ey:
<br /> ���t��—�-- Dato: [1 ya '�I��4AJA(ILTC•471Ei11�-1�IS�RIG��--�
<br /> Ay� •.� ,i..lo/%/.._
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