10030 HOLLY DR 2016-01-01 MF Import

MUKILTEO WATER DISTRICT I SNOHO�dISH COUNTY WASHINGTON � � �-'� � APPLICATION FOR WATER � �C � ApplicaliontJo. �_ �� No. ��__ MeterSize � NumberofUnits - -S AccountNo. �S-a7Q//c�S I hereby apply for water service and agree to be governed in accordance with the resoiutions, n�les and regulations of the PAUKILTEO WATER DISTRICT pertaining to water service, ncw or hereafter in etfect. The undersigned as owner or representative of the herein-described premises hereby agrees as follows: (1) Th.;t the cost of any extension of tho water service,renewal,replacement or repair to reach and serve the properry descnbed shali be bome by myseif or assigns as owner(s) of tue pmmises. (2) That all pipes,water measurirg devices and etherconnecting equipment upstream from the meter shall,a(ter their in;tallation,be and beceme the properry of the MUKILTEO WATER DISTRICT,subject ro ail its mgula6ons pertaining to water service. (3) That at�erinstallation,if ineter or meterhox andappurtenws aro buried ord�maged,tho owner,will ho held responsible and charged for same. (Q) That the MUKILTEO WATER�ISTRICT,its cfficers and agonls,shall have tho right of ingress and egmss to c�o upon ihe premises and pmperty described herein for tho purpose of'��spectian,aonnocling or disconnocung the servico or far such other purpases as the service may require. It is a;so understaod during ihe timo that any ol tho water mains may be out nt servico by reason af any emergency or improvements authorized by Ihe DISTFICT,in any street or olher location in which they may havo heen laid,the DISTRICT will not be reGuired ro furnish water during tho progress o(such improvements ro any cansumr�r whose supply may thus 6o cut otf,or ho liablo Inr any damages lor its faiWre to do so. (5) That ihe DISTRICT shall havo tho right to chango the rates at any time hy Resolution,ro temporarily discontinue tha sorvice to consumers,and to�install tho meter(s) to registcr the a•ater consumed. The DISTRICT shall not be held li�hle far damage 6y waier or other cnuse resw�ing from de!ec;ive ptumhing or appliances installea by the owner oroccupant on the premises supptied with water,and the fact th�t agenis of the�ISTRI CT may havo inspected tho plum6ing and appliances shall no[bo plaad as a basis for recov�ry in case of damage as aforesaid. It the supply o( : ✓ watershallfailorbeinterruptedbyreasonofaccident,lowpmssuroorolhercausewhatsoever,theDISTRICTshallnotboheldlia6lefcrdamages � norshallsuchfailureorinlerruptionlorany� ;asonabletime6oheldtopns6tuteahreachofcontractonthepartofthr.DISTRICTorinanywoy reliove tho wnsumer,whether tenant or ownor,Iram pedorming the obtigation ot such tenanl's or awner's con!ract. Warer shall 6e used 6y , - ✓� applicant anly on iho premises descrihed horein. A new appiicaticn sh�ll be filod shauld water 6a desired tar other premises although located �t� on land descri6ed herein. x,�nrt��'� (6) Tha� the DISTflICT recommends Installallon of a prcssurn regulating vnWe. Applicanl acknowledges infarmatlon as to Ihe . � recommendatlon and assumes luli responsiblll;y for installing or falling to Inslall a ptessure regulaling value an Ihe waler system to ' � `L--� pro�ect It from high pressure. ' x�-�r/��(7) The DISTRICT utilizes check valves al the meter to prevent waler reWming to Iha Dlstricls mains. The DISTFICT recommends � � V inclallaGonafathermalexpnnsfontanktoprevenlezeesslveprossuro6uild-upcausedbythewalenc�ater. Applic�nlsacknowledges i� i Inlormatlon as lo tho mcommelnda�(on and assunmes full respansibilly lor Installlnc�ar faiiing ta Inctall a Ihermal expanslon tank. SGFVICE ADDRESS: _�OO�V�' �FIO/�I I�� '\ LOT N0. BLOCK �LG✓� y�—�<� PLITNAME: � CITY/STATE/ZIP: � L / / Z LEGAL DESCRI�PT1ION: f J '/ � � OWNER'S NAME: U�I �r/1 C (JY�� LV � T V� �• OWNER'S ADDR[SS: �O �G7( I J�I 1 �7�/rn CITY/STATE/ZIP: �I Iz U L1'e.r L�/� �-1 �L✓�� The premises arc ,a ho used s a �' `'� �� i y INFORMATION LETTER-GAVE/SENT: � � CHARGES: , (t)Servico installaoon 8 connection cl4mgo 5 r� 25J �U� � � (2)Genaral Faciliiies connaction charge S L� SS ' �v - , (3)Other g -- ' " Total amount receivedwith application $ 2��/ UU , IT IS UNDERSTOOD that this Applicalion,although signed,shatl not ho binding upon tho MUKILTEO WATER DISTFICTuntil approved by the GISTRICT. 7�ii � I, the.undersigned,owner(or representativo)of�ho propetly doscribed atiovo,do hereby make applicaGon for insWllation of a PAif� -inch di❑moter wale up y scrvico connection,i udin utlenances,and all r�oc sary labor at my expenses. Dated ihis �__day af e �� ,9 JUN p 6 1996 APPLICANTS SIGNATURE: — � �A-�� . Applicanl'sNamo (pleasaprinl): �� /'�'�✓; ��+dn ] MUKILTED VVATER DISTRICI � _�� Applicanfs Addross and Nhono Numh�� l rQ i � l.1 �f� i 1'U � �/� �_J� �=�L'l�)`} �� —�`/C�d APPRQVED: _ II� U�b�C� (-U �5�1O� MUKILTE R/DlSTRICT °','' / � �! —" Dato: ,�:_LLG_L'�G i % / ._ .. . _. __—_. __ -.� 'r�:•.� :r`:;�.;,•' .:.`�t^.'�',r.��'�.,-4 c� rd`� xv:.."..�_ �„'��R. .di,Y. �7+tr,