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' '+� . / � O I. �MIJKILTEO WATER DISTFIC7 � �-�—� j . �I
<br /> SNOHQMISH COUNTY WASHINGTON � G G C � . ',
<br /> � �_�" '
<br /> APPLICATION FOR WATER �
<br /> ;� " Z � ,� � �:�s- 1�,; /in
<br /> )ApplicationNo. ��� � No, (';���-0'�-r� i
<br /> /^ ,� t
<br /> MeterSize �� NumberofUnits ���'� •������•� AccountNo. ('7a�S'�7D ///�
<br /> I hereby appty for water service and agree to be governed in accordance with the resolutions, rules and ;egulations o•the �i
<br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereaiter in effecL The undersigned as owner or
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<br /> representative ot the hereimdescribed premises hereby agrees as follows:
<br /> ' (7) That the cost o(any extensinn of tho water servico,renewal,replacemen�or repair to reach and;ervo the property described shall be bemo
<br /> by myself or assigns as ownor(s) oF�he premises. '
<br /> (2) That a!I pipes,water measuring devices and otherconnecGng equipment up�:eam fmm ihe mo�ershall,aReriheirinstallatinn,ho and become
<br /> the property o:Ihe MUKILTEO WATER DISTRICT,su6jec[ro all its regulationc pertaining to water service.
<br /> (3) Thata�terinstallation,ifineterormetorboxandapputlenwsaraburiedordamaced,theowner,willboheldresponsibloandchargedforsame.
<br /> (4) That the MUKI LTEO WATcR DISTRICT,its officcrs and agents,shall havo tho ngnt ot ingross and egross to go upon tho premises and pmperry
<br /> described herein for the purpose af inspection,conn�cting or d'sconnacGng tho sr.vico cr for such other purposes as ihe service may requim.
<br /> It is also understaod during the timo that any ol the water rt,ains may be out of serv'ce Ly:eason of any emergency or impmvcmenis authorized
<br /> by Ihe DISTRICT,m any street or other location in whir,;t�ey may have been'aid,Ih�DISTRICT will not 6e required to fum ish water dunng
<br /> tho pr�gress of such impmvoments to any consumar whose supply may thus bo wt olt,or bo 1ia61e for any damages tor its faiWre to do so. �
<br /> (5) Thot iho DISTRICT shall havo iho right to chango iho rates at any tims hy Re;olution,to temporarity disrontiwe tho service m wnsumers,and
<br /> ta install ihe meter(s) to re9ister tho water consumed: Tho DISTRICT shall not 6e held liable lor damage by water or other cause resulting from
<br /> dofectivo plumbirg or applianees install�}�q�ner or occupant on the premises supplied with wa�er,and th�lact;hat a�ents of the D ISTRICT
<br /> -. may havo inspected iho plumbing and ap�dc 5 shall no[be plead as a basis lor recovery in case of damago as abmsaid. If the supply of
<br /> . - watefs�jalllailcrheinF�rmptedbyreasonofaccidont,lowpressurearothercausowhatsoever,thoDISTRICTsh�llnotbeheldliablufordamages
<br /> ' narspall°suchfaiWreorinterruptionforanyroasonableiimabeheldtocanstiWteabreachofwntractanthepartottheDISTRICTarinanyway
<br /> "� ��� , relievM�ho wnsumer,whaher tenant ar awner,fmm pertorming the obliga6on af such tenanCs ar owner's convact. Water shall bo used hy
<br /> �: ��"�`��� ��applican'.only on Iha premises described harein. A n3'.v applicauan sNall bo liled should water be desired for other premises aithough located
<br /> � 'i4'�`�. on land described hercin.
<br /> .wt /(��`(6) Thot the OISTRICT�rerommends Installa�lan of a pressara regulating valve. Applicani acknowledges InFormatlon as to the
<br /> �rc'commendatian ditd assumes lull responsiblllty for Ins�alling or fa(I(ng lo Install a pressure regulaling value an ihe waier sys�em to
<br /> pro�ecl It Irom high pressurc. �
<br /> irar��. (7) The DISTRICT ulilfzes check valves at Ihe meter �o prevent wa�er returnin9 to the Dlslri:�s main�. The �ISTRICT recommends
<br /> -� . ' insWllaiionolathermalexpansfontank�oprevenlexce^,sNepre^,sure6uild-upcausedbythewaturheater. Applicanisacknovdedges
<br /> � � �,. ,intormadan as lo iho recommendalion and assumes full respanslbllry for installing or falling to Install a�hermai expanslon tank.
<br /> J�� SERVICE ADDRESS: _l':v�U_,���u���( i�P LOT NO. 6LOCK
<br /> � /�'n+ i,�F '* 'I !�
<br /> " ' T'"`''�""r PLAT NAME:
<br /> ���CITY/STATE/ZIP: r{�� v-':'rN Lt/A ��1 ZUj I.EGALDESCRIPTION: S�.l� �, '�j p„�
<br /> OWNEFi'S NAME: �7' �-�ci d r a,i f U�L.(9 . .
<br /> - :� OWNER'S ADORESS: ��' ��%� ���% . F # �`l I �
<br /> �.-..� CITY/STA7FJZIP: ��t' � ��'V�.1..'�'., �a �7� L�fi.�J •
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<br /> The premises am to bo used as a �" '''�"• .� �
<br /> _ �� U I� i — �Cc i» � I..l INFORMATION LETTER-GAVE/SENT: � � ,
<br /> � � ' , CHARGES . ,PAID_
<br /> (t)Servico inst�!!ation&connection ctiargo 5 SU��. /(r
<br /> (2)Geneml Facilitios wnneclion charge $ � � ���• � � � APR 519961
<br /> ;�;om�� 5 MUitILTEO WATER DISiRICT
<br /> / Co7 �, 1(n •
<br /> Tatal amount reccived with appliptian S . �
<br /> IT IS UNDSRSTOOD that this Application,although signed,sholl not bo binding upon tho MUKILTEO WATER DISTRICT until apprcved by the DISTRICT.
<br /> I, ihe undersigned,owner(or representative)of tho property descnbed above,do heroby mako appliwtion lor installation af a �/L -inch :�
<br /> diammer watar supgly servico connection,incl din�appurtenances,and all ne sary labor at my axpensos. �� •'
<br /> Dafed this 5`%j' day of •Ji; l ,�g �l(� .
<br /> APPLICANT'S SIGNATURE: — i �� ��`'�"'`'�'�-
<br /> -. ApplicanCs Nama(ploaso prinl): k1�✓l�-�+�' �CT`Q�� `�
<br /> �.�� ApplicanCs Adcress and Phono Numbor. /O' �r� ��� .�F/L+r�-(f(J� L..Yt . `7�ek_+� �.
<br /> APPROVED:
<br /> MUKILT TER DISTRICT
<br /> 8y: � ��,,,� _ Dafe:
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