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. . . .� . . ' _rr- . .. ... .�-. <br /> � MUKILTEO WATtR DISTRICT � • <br /> SNOHOMISH COUNTY WASHINGTON G� � �� , <br /> � APPLICATION FOR WATER �~ / <br /> c <br /> � 'i � <br /> . Application No. I� No. ��n��Q���_ � <br /> t�leterSize ��� NumberofUnits ' .3 AccountNo. ��'���/{�S— � <br /> I hereby appiy for water service and agree to be governed in accordance with the resolutions, rules and reculations ot tbe <br /> P✓�UKILTEO WATER DISTRICT pertaining to water service, now or hereafter in ef(ect. The undersigned as owner or <br /> representative of the herein-described premises hereby agrees as follows: <br /> r;) That the cost af any ext@nsion of ihe water service,renewai,replacement ar repair to reach-and serve the properfj described shall be borne <br /> by mysclf or assigns as owner(s) of the premisoc —�' j( ���i_, �'C-� '� '. :..1 , <br /> r2) That ali pipes,tvater measuring devices and otherconnecting eGuipment upstream fram tho�me�ershall,after their installation,bo and become <br /> the property ot tho MUKILTEO WATER DISTRICT, subject to all its regulafions pertaining to water service. <br /> (3) Thotalterinstallalion,ifineterormeterhoxandappurtencesaroburiedordamaged,ihoovmer,�vill6eheldrecponsibleandchargedlorsame. <br /> (1) ThauheMUKILTEOWATER�ISTRICT,.itsolficersandagents,shallhawthorightolingressandegresstogoupon;hepremis�safi�J pr erty <br /> described herein loriho purpose of inspection,connacting or disconnecung Ihe serviw or for su er purposes as the service m5y-(e�uire. <br /> Itis�isoundcrstoodduringthetimetha[anyotthowatermainsmaybeouto�se reasonofanyemergencyorimprovementsauthorized <br /> by the DISTRIC7,in any street or other location in which they may havo 6een laid,�he DISTRICT will not be requimd ro fumish water during <br /> the progress af;ech improvomonls to any consumer whose supply may thus tre cu[aff,or be liabte icr any dumages lar its failure to do sai <br /> (5) That the DISTRICTshall hava tho nght to chango the rates at any time by Resolution,to Icmporarily di;continue tho service m consume�s,and <br /> toinstalltheme[er(s) toregistcrthewalcrconsumed. ThoDISTRICTshallnotbeheldliabielordamagebywaterorothercauserc VNipy from <br /> defective plumbing or appliances installed by the owner or occupant on Ihe premises suppliedwith water,and the fact thatagentsvf the DISTpICT <br /> may have inspected the plumhing and appliances shall not bo plead as a basis for recovery in caso of damaye as aforesaid. If the suppiy of <br /> water shall lail or be interzvpted by reason of acddent,law pressuro or other causo whatsoever,tho DISTRICT shall not b�t held 1ia61e for damages <br /> nor shall such failura orinterruption larany reasanablo�ime be heldto wnstitute a breach of wntmcton the part of the DISTRICTor in any way <br /> relicve the cansumer,whether tenant or owner,from perfarming tho o6ligation o(such tenanfs ar owner's canuact. Water shail he used by <br /> applicant only on tho pramises descrihed herein. A naw applicaGon shall be liled;hauld waterbo desired for ather premises althouc�h loca�ed <br /> �/�� i, on land duseribed her in. ' <br /> ir�r � (G) Thal Ihe DISTRIC rerommends fnstaliation ot u pressuru regulaling valve. Applfcant acknowledges infotmatlon as to Ihe <br /> recommendatian a d assumes tull respansibility for Installing or fallfng lo Install a pressure reguiating value on the water syslem�o <br /> / protect il(rom high pressurc. , � �,�� ' <br /> r.�r __�'(7) The DISTRICT utilizes eheek valves al lhe meter to prevenl waler relurning.lo�the Disiricts malns. The DISTRICT recommends <br /> —. installa�iona�alhermalexpansiontanktoprevenlexcessivepressurebuild-upcausedbythowalerhea�er.Applicantsacknowledges <br /> j � - Informatlon as to tho reeommenda�lon and assumes full responsl611�y for Installing ar lallfng�o Install a thermai expanslan tank. <br /> SERVICE ADDRESS: ��/`VU ��D��� �2• LOT NO. g � BLOCK <br /> �`�J -�7 7 PLAT NAME: /�/�Y/��').�j C'.�;�V� - <br /> CITY/STATE/ZIP: LV�J��f� ��' �7 LEGAL DESCRIPTION: !CXT ��� <br /> OWNER'S NAME: �-'IyI�/��/7!l/J7 ���'f� �L�J .<Y � <br /> OWNER'SADDRESS: rv '���X I3O <br /> CITY/STATE/ZIP: �f��F�ll�� /��• �B�GYJc/ . //�-:2900 � <br /> The premises am to bo used as e � � <br /> �JII��/� f,lll�%Ly INFGFMATION LETTER-GAVE/SENT: � •' � <br /> CHAFGES: <br /> � (i)Scrvico installation&connection chargc S �5� �U <br /> (2)Gereral Facilities connection chargo 5 �����•�U � <br /> � (3)Olher S � U ' <br /> � To�al amount received with application 5 3�p� DO <br /> IT IS UNDERSTOOD that this Applicalion,although signed,shall not ba bindng upon tho h1UKILTEO WATER DISTRICT until approved by the DISTR�CT. <br /> ., �he undersigned, owner(or represonlaGvo)of tha property doscribed abovo,do hereby mako application lor insWllaGon of a �_-inch <br /> d ameler walor^u ply serviw connection ndudipg appurtenancos,and all nocessary labor at my expensos. <br /> Dated Ihis _ � `-� day of �/�r)(�J't ,19 �� , <br /> i <br /> APPUCANTS SIGNATURE: ��^�- \ � 'a,=��b'4� .U 7 � <br /> , ApplicanCs Namc(please prinQ: "�^''�Vk ' 4G id"��Y� -p/��,�/?� ,� '�k"" <br /> � �� ApplicanCs Ad�ress and Phone Number. I � v- �V X I2� rJE�L��b}� 'd. �I���� <br /> APPROVED: `��5 — �C� <br /> MUKILTEO ER DISTRICT � _ y. <br /> �' 1., �, t . „ - � <br /> -� <br /> Date: _�.!! ' � <br /> / <br /> Il�i�i+l I <br />