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. o <br /> . . , <br /> 'MUKILTEO WATER DISTRICT � <br /> SNOHOMISH COUNTY WASHINGTON � <br /> APPLICATION FOR WATER � . � �" <br /> ����� `� /a� ;,. . � qa-s�s <br /> Application No. .�` No. �� C <br /> Meter Size 1 �� Number ot Units Z' Account No. .I��-�73 7��- C� <br /> I hereby apply lor water service and agree to be governed in accordance wilh tne resolutions, rules and regulations of the ` <br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in effect. The undersigned as owner or � <br /> representative of the herein•described premis2s hereby agrees as follows: 1 <br /> (1) That the cost of any eztension of tho water sorvice,renawal,mplacoment or repair to roach and servo the property described shall he bome � <br /> -by mysolf or assigns as owr�er(s) ot tho premises. �r <br /> (2) That all pipes,water measuring dovices and other connecting equipmen[upstroam from the motor shatl,attm thoir installation,be and becomo <br /> the propr:rty ol the MUKILTEO WATER DISTRICT,suhjoct to nIl its re�ulaGons portaining to wator sorvice. �. <br /> (3) That alter installation,if ineter or meter boz a�d appurtencos are buriod or damaged,tho owner,will ba hold responsible and chargad lor same. — <br /> (4) That tho MUKILTEO IVATER DISTRICT,its oflicors and ngonts,shall havo tho right of ingross and ogross to go upon the promises and pmperry `; <br /> described horein for the purpose of inspection,connacling or disconnecting tho sorvice or for such other purposes as the service may requira. <br /> It is also understood during the timo that any ol the water mains may be out ol service hy reason ot any emorgency or improvements authori.ed L <br /> 6y ihe DISTRICT,in any street or other location in which ihey may haw boen laid,ihe DISTRICT will not bo required ro fumish water during <br /> the progross of such improvoments to any consumor whose supply may thus be cut oH,or bo li�ble for any damagos for its failuro to do so. 4 <br /> (5) That�ho DISTRICT shall havo tho right to chango the ra�as at any time by Resolution,to tomporarily disconGnua tha sarvice to consumers,and -� <br /> to install thc meter(s) to rec�ister the wamr consumod, Tha DiSTRICT shall not be hald liable lor damage by water or other wuso resulting Irom <br /> dofactiveplumhingorappliancosinstalledbytheowneroroecupantonthepremisessuppliedwithwater,andthafactthatagentsoftheDISTRICT � <br /> may have inspoctod tho plumhing and appliances shall nol be pload as a basis fo-rocovory in caso of damago as aforesaid. If the supply of � <br /> wntershalltailorheinlerruptedbyreasonolaccident,lowpressuroorotherwusowhatsoaver,ffioDISTRICTshallnotbeheldliablatordamnges � <br /> nor shall such lailure or iNermption lorany roasonable timo ho heid to constituto a breach ot contract on the part of tho DISTRICT or in any way � <br /> �� rolieve tho consumar,whothor tenant or ownor,Irom pedorminp tho ohligation ol such tonanCs of ownePs contracl. Water shall 6e used hy <br /> appiicant only on tho pmmisvs desaibod horein. A new appliwtion shall bo filed should water ho desirod lor othor prumises nllhough located \ <br /> on lond desaibed herein. � <br /> iy;,._ (6) That Ihe DISTRICT recommends Inslnllaifon of e pressure regulating valve. Applicent acknowledges Inlormatlon as to the �I <br /> � tecommendation und nssumes(ull responsiblllty lor Installing or lalling to Install e pressure regulaling value on tho water syslem to <br /> prolect It irom high pressure. � <br /> wr _ ._(7) The DISTRICT ulllizas cheek valves ot �ho meler ta prevenl wuter reWrning lo Ihe Dis�dcts malns. The DISTRICT recommends <br /> Instellutfonolalhermalezpenstontanktoprevenlexcesslvuprossurebulld•up�ausedbylhewaterheater. Applicenlsaoknowledges <br /> ' �� Infarmatlon as ta ihe rrtcommnndnl(on and assumes lull respons1611ty tor Installing or 1 tling to Ins�all e lhermal ezpansion lank. <br /> /SERVICE ADDRESS: —�� .��►'Cx.� LOT NO. � � BLOCK � _ <br /> PLAT NAME: �f���-� 1�J�='` <br /> CITY/STATEJZIP: �'d,���,(�fF Ci o Z�� LEGAL DESCF�P]T�I�O/IQ: t� � � ��' <br /> OWNER'S NAME: ��� J�"�4Tit d' M� <br /> 01VNER'S ADDRESS: � � —� � w <br /> CITY/STATE/ZIP: N Fl d <br /> — i <br /> Tho premises are to bo used as a � � ' <br /> �uP�''��` INFOPMATION LETTER-GAVE/SENT� " <br /> CHARGES: <br /> (1)Servica installation&connection charge S ��/�� <br /> (2)Gonoral Fndliuos connacGon chargo S �� h�n . ` 7�J <br /> (3)O(hot ! S /� <br /> Total amoum rcceived with applicafion 5 — �J h�n �l l <br /> IT IS UNDERSTOOD tha�this Appliwtion,although signad,shall not bo binding upon tno MUKILTEO WATEF DISTRICT until approvod by thc DISTRICI. <br /> /� <br /> I, the undersignod,owner(or represontativo)of tho property described obove,do hereby make applicalion lor inslallntion ot a _�-inch <br /> diameter wator su ply sprvico c nection,including appurtenances,and all necessary labor at my oxpensos. � <br /> Daicd�his '�2 da�of �i G - ,19 9� . , <br /> � . <br /> APPLICANTS SIGNATURE: ` ' �7 �AID <br /> G' r- �� , ' <br /> . Applicanfs Nama (pioaso pnnt): / <br /> `� AppliwnfsAddressandPhonaNumbcr: L�1NN(1]��� c.c)A �J�iD�7 OCT 121992 <br /> APPROVED: <br /> MUKILT WATER DISTRICT MUKIL7E0 WA7ER DISTRICI <br /> By� �_ Date: �v /2 <br />