|
��� • . ' ;J�': `. t ' !:i� '� .n;
<br /> ' � MdKILTEO WATER DISTRICT " +' '� ` ' �^
<br /> SNOHOMlSH COUNTY WASHINGTON
<br /> � . �.
<br /> �,, , APPLICATION FAR WATER _��(;_ �, 1 //� r �
<br /> � . / / -� 4 " � ���L�
<br /> -- �Applicalio n No. �� ' '" No. Ns a� a;�,�p,�_,���
<br /> Meter Size 3�� Number oi Units � Account No. D�20' /�U I7cl�'(d'.•78:
<br /> �
<br /> I hereby apply tor water service and agree to be govemed in accordance withihe resolutions, rules and regulations of ihe
<br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in etiect. The undersigned as owner or
<br /> representative of the herein-descri6�tJ pPemises hereby agrees as foilows: C
<br /> (1) That�he cost of any exlension of the wator sorvico,renewal,replacament or ropair to raaeh and serve the property described shall be borne �;
<br /> - by mysell or ussigns as owner(s) o�tho promises. C
<br /> (2) 'fhat all pipos,water muasuring dovicos and other connoetlng oquipment upstream imm tho motor shall,aherthe�jr installation,be and become l
<br /> the proporty ol the MUKILTEO WATER DISTRICT,subjoct to ell its regulations pertaining to water serviee. �
<br /> (3) Thnt alter instaltation,il moter or meter boz and appunencos are buriod or damagod,tho ownor,will be hold responsible and chargad for same. �
<br /> (4) That tho MUKILTEO WATER DISTRICT,its otficors and egonts,shall have the right of ingress and agross to go upon the premisos and properry �
<br /> dosaibod horoin for iho purposo ol inspection,connecting or diuon�ecUng the service or for such othor purposas as the service may require, C
<br /> It is also understood during tho time that any of tho water mains may be out ol service by reason of any emergancy or improvements authorizod �
<br /> by tho DISTRICT,in any svaet or othor loeation in which they may have been laid,the DISTRICT will not be required to furnish water during �
<br /> tho progross of such improvemnnts to any eonsumerwhose supply mey thus he cut ofl,or be Iiable for any damagos for its failure to do so. �
<br /> (5) That tho DISTRICT shail haw tho right to change tho rates at any time by Resolution,to tamporarily discontinuo the servico to consumors,end �
<br /> toinstalithomr+ter(s) toregislarthewatorcon5umesl. TheDISTRICTshallnot6eheldlia6lofordamagebywaterorothereauBerosultingirom a
<br /> dafoctive plumbing or appiiances instnlled by,t�hoownor or ocwpant on tha prnmises suppliod with wator,and tho fact that agents of tha D ISTRICT
<br /> � may havo inspoctod ihe plum6ing nnd applionce;.�all not bo plead as a basis for recovery in ease ot damago as aforesaid. If lhe supply of p�
<br /> watcrshallfailorbointorrupledbyrcasonol�ccidont,lowprossureorotheresusowhetsoovor,theDISTRICTsha�lnotbeheldliablefordamages �
<br /> nor shall such failurc or interruptio�for any roasonablo Gme bo huld to constitute a broach of contract on the part of the DISTRICT or in any way p
<br /> roliove tho consumor,whothor IonAnl or ownor,from periorming the ohligation ol such tenanPs or owner's eonVact. Weter shall be used hy
<br /> app�icant only on tho promisos describod heroin. A new app�icaGon ahall bo filod should water ba dosirod lor other promises.although•located �
<br /> �) ,� on land doscribed heroin. �� -� � � ��
<br /> INT � (6) Thnt the D�STRICT reeommends Instellalfon a( a pre.sure reguleting valve. Applicent acknowledgee Inlormetlonias�t0-the
<br /> recommendetion and aseumes full responslbllity lor inetalling or lelling lo Insletl e pressure regulating value on tha weter:system`to
<br /> -��.k! protect It Irom high pressure.
<br /> iNr (7) Tho DISTRICT utilixes check vnlves at the mefer to prevent waler ietu In nr g to the Districts maine. The DISTRICT racommends
<br /> -�') Insteilntfonofathermelezponslontanklopreventezeesalveproasurobuild•upeawedbythewatarheater. Applienntsaeknowledgea
<br /> ` Inlormetion as fo tha rocommendetion and acsumas tull respon�lbllly lor InatalllnB or fallinp to Instell a thermal expancion tenk.
<br /> SERVICE AODRESS: ����� �-�'����� �� �� LOT NO. �
<br /> BLOCK
<br /> PLATNAME: JF77.�.�c /_iH:v.
<br /> CITY/STATElLIP: Ur���� LEGAL DESCRIPTION: y� ��� uL�� �'
<br /> OWN'cfl'S NAME: J✓97'!�Lt. /ii/�(d !.�,y.N.'lE' �
<br /> OWNER'S ADDRESS�:���� � �"�r+�`_t� •f� i� �`/i.i� �� , �/,�—�ji ., ;�, j F
<br /> CI7Y/STATE/ZIP: ���:�i�Y""`'f^ /"/„�Y/,�L°U
<br /> Tho promisos are to bo usod as n �.��dll �.ZP^%%'/�' �" °y �'`�'��
<br /> �S/� INFORMATION LETTER•GAVE/SENT: 1�f�--
<br /> ,
<br /> . ��� � CHARGES: ,t�A�
<br /> ,� � F
<br /> (1)Sorvico installation&connoction charge .5 �'3�-'�-�
<br /> (2�Genaml Facilitlos connacfion chargo . 5 ����'���� DEC � 8 2002
<br /> �s�omor � � MUKILTEO WATER DISTRICT
<br /> Total amount rocoived with applicatlon 5 ��C�S•�`J
<br /> IT IS UNDe"RSTOOD thal this ApplieaGon,aithough signud,shall no�bo bindn9 upon the MUKILTEO WATER DISTRICT unti�approved by the DISTRICT.`'
<br /> I, the undersignod,ownnr(or mprosontalivo)ol tho property doscribed ebove,do horuby make application lor installation of a '��y -ineh
<br /> diamoter water suppl�sorvico connoction,includng appurtonances,and uIl neeessary labor al my expenses.
<br /> Datedthis �� dayol ': '�. ' r- -�
<br /> . , ' i d'J.-.
<br /> APPLICANTS SIGNATURE: �-•—`�-`�'�` L `' �` �� \ �_ `�
<br /> ,�..�,. - I !•�",l-. .. �',.� ' 1� + .•1'`' - ��� �1'1 )!; � %i'1'. ��'r� ��, .
<br /> ApplicanPs Namo(pleaso pnnq: 1
<br /> `-�!'�ApplicanPs Addross and Phono Number. �✓�� ��l- � � ' � � � � �� � ` ��f '����c f l � - ' '
<br /> APPROVED:
<br /> MUKILTE TER DISTRICT
<br /> By� � �'7 Dn�e: J Z I� �vv:._ �
<br /> R� �
<br />
|