Laserfiche WebLink
. . - - . _. .. _� � � . _ .. ..T� � • .n� . . • . . . . _ • <br /> � r���� .... � � Q <br /> _ /,��' �' � 6 <br /> MUKILTEO WATER DISTRICT _� -- <br /> SNOHOMISH COUNTY WASHINGTON � ,� O <br /> ��_ � �,� � <br /> APPLICATION FOR WATER � ` y�- DOy <br /> ^� ��f� �� <br /> Application No. � -� No. �+r��� <br /> Meter Size , �� Number of Units Account No. a.�0^'��OG���� � <br /> I hereby apply tor water service and agree to be governed in accordance wilh the resolutions, rules and regulations of the � <br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereatter in eifect. The undersigned as owner or � <br /> representative of the herein-described premises hereby agrees as toilows: � <br /> (1) That tha cost ot any extension ol ffio water service,renewal,replacement or repnir to reach and serve the proporty describod shnll ho bame <br /> by myso�f or assigns as ownor(s) ot the premisos. � <br /> (2) That all pipos,water measuring dovices und other connecGng equipmont ups[ream Irom tha molor shall,ahor their Installation,bo and beeomo �( <br /> the proporty ol the MUKILTEO INATER DISTRICT,suhjact to all its rogulaGons pertaining to watar sorvice. C <br /> (3) That afror installation,if motar ormetor boz and appurtenws are 6uriod or damagod,Ihe ownor,will 6e hcld responsiblo and chargod for same. <br /> (4) That thc MUKILT"c0 WATER DISTRICT,its olfwrs and agonts,shall haw tha right of ingrass end egross to go up�n Iha promises and property <br /> described heroin for tho purpose of inspoction,connocting or discannocting the service or for such other purposos as the sorvice may require. <br /> It is also understood during tho fimo that any of the water mains may bo oul of service by reason of any emerganey or impiovemenis authorized <br /> by the D�STRICT,in any stroot or other locafion in which they may haw boen laid,the DISTRICT will not 6e requirod to fumish water during <br /> tho progross of such improvoments to any consumer whose supply may Nus bA cut oH,or be Iiahie for any damages for its failure to do so. <br /> (5) Thnt tho DISTFICT shall how tho right to chnngo tho�atos at any time by Rosoiution,to tomporarily disconGnuo tho sorvico to consumers,end <br /> toinstallthometcr(s) toregistorthewatarconsumed. TheDISTRICTshallnotbohaidliablefordamagebywaterorothcrrausorosultingtrom <br /> dolective plumbing ar applianws installed by the ownor oroccupant on tho premises suppliod with wator,and tho fact that agems of tho DISTRI CT <br /> may havo inspocted the ptumbing and appliancos shall not be plaad as e basis for tocovory in caso ot damago as aforosaid. If the supply ol <br /> woter shall tail or he intorrupted by roason ot accident,low pressuro or other causo whatsoovor,tho DI STRICT shall not ho held liablo for damagos <br /> nor shall such lailuro orinterruption forany roasonabie timo bo hold to constitulo a breach of contracton the pan of the DISTRICTorin any way <br /> rolieve the consumor,whethur mnant or owner irom podorming tho obligaGon ot such tenanPs or owner's convact. Water shall bo used by <br /> applicant only on tho promisas describod horein. A now application shall ho lilod shouid walor be dosirod lor othor premisos although located <br /> � on land dascribed herein. <br /> ir�; ��6) Thol 1he DISTRICT recommends Instalintion ot a pressure regulatfng valva Applieant acknowledges In(ormatlon es to the <br /> recammendntlon and nssumes lull responslbllity for instolling or lalling to Instoli e pressure regulaiing velue on the water system to <br /> �/�1 � protect It(rom high pressure. <br /> iNr W!�'(7) The DISTRICT uUlfzes check valves at tho meler to prnvent wator re�urning to the Districts melns. The DISTRICT recommends <br /> ��} Installa�Ionolathermalaxponsioninnktopmventexcusslvepressurebulld-upceusedbylhewaterhea�er. Appllcaotsacknowledges <br /> V Inlormatlon us lo tho recommendetion and essu'm/es full responslbllty for Installing or talling to Instell a ihermel ezpension tank. <br /> SERVICE ADDRESS: I�.��� ���IrO�� IN,�7 LOT NO. ( BLOCK � <br /> '/ ^ ,�/ PLAT NAME: �f .f/C�i) T�c�.-�/�Y <br /> CITY/STATE/ZIP: ��l� ���. U✓/-f . �% LEGAL DESCRIPTION: Ls�G.G�— � L d'�'- <br /> OWNER'S NAME: �✓'�ALU Y�' C/L�/7fY � �- 9 , <br /> OWNER'SADDRESS: l�D• �OT �9� 7� �A' S� ��-O� q. <br /> CITY/STATE/ZIP: ���t' STEU'��/S' ��/A . 9�s' <br /> Tho premisos arc ro bo usod ns a - , i��L f= X <br /> i�r;� <br /> IN'rORMATION LETTER-GAVc/SENT: X '� ' <br /> CHARGES: <br /> (t)Servico installation&connection charge 5 ��CO. (�✓� 1 <br /> (2)General FnciliGos eonncetion chargo $ �1�• ��v <br /> (3)Olher � <br /> Total amount raoived with app�iqfion 5 - �yr,"0 • l <br /> IT IS UNDcRSTOOD thot this Application,althouc�h signod,shall not bo hinding upon Iho MUKILTEO WATER DISTRICT until approwd by the DISTRICT. <br /> i <br /> I, the undersignod,owner(or represontative)af lho property dascribod nbovo,do hereby mako appliption lor insWllaGon ol n � -inch <br /> diomoter wator supply sorvico connection,including appurtonances,und nll n��9cossary labor at my oxponses. <br /> Dated Ihis � � day ot ) /� � ,19 `7 D • , <br /> �� <br /> / 9 <br /> APPLICANTS SIGNATURE: �` :1�,^ ��ir�-���"� � <br /> 4pplicanfs Name (ploaso print): c�.�L�✓ ���L r�i�. P�D <br /> � � NOV 2 7 1990 <br /> �--AppiicanYs Address and Phono Number: � � � >�1 � �� �-- <br /> APPROVED: LA ��'r ��U�i1iC� ly�r_ C/,('i �� <br /> � ,-� <br /> MUKILT�O WATER DISTRICT �> > > '�fa .MUKILTEO WA7ER DISiRICi <br /> ^�"�."?— v% "�c:_..-;-�_ Zo 27 ,-� _ i i�i <br /> BY:-�'-+ .� > Dale: " rj � � , <br /> A7 ./.+ 7i e _ / � <br />