|
a
<br /> 1
<br /> MUKILTEO WATER DISTRICT
<br /> SNOtiOMISH COUNTY WASHINGTON / � �,� -�
<br /> APPLICATION FOR WATER
<br /> _ 7 / �� No. � !W�4, �
<br /> Application No.
<br /> MeterSize I ' a '1 NumberofUnits AccountNo. �Ji$-a7�/��J �
<br /> .- ,
<br /> I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations of the
<br /> MUKI�TEO WATER DISTRICT pertaining to water service, now or hereafter in elfect. The undersigned as owner or �
<br /> rep,esentative of the herein-described premises hereby agrees as follows: •
<br /> (7) That tho ce-�o'any extension o(tho water sorvice,renowal,replacement or repair to reach and serve the pmperty descnbed shall bo bome
<br /> hy myself or assigns as owner(s) of tho premises. �
<br /> �2) That all pipes,water measuring do�ices and other cunnocting equipment upstruam hom tha metor shall,after their InsWIlaAun,bo and hecomo
<br /> ,he proporty of tho NUKILTEO WATER DISTRICT,subjoct to all its regula6ons partaining to water servico.
<br /> (3) That after installation,it meter or metor box and appurtoncos aro buriod or damaged,tho owner,will bo held responsible and chargod for same. �
<br /> (4) That iho MUKILTEO WATER DISTRI CT,its alf rArs and agonts,shall have tho nght of ingross and ogmss ro go upon tho,�remises and property
<br /> deseribed harein tor tho purposo of inspee6on,connocting ar diseonnoeting tho sarvico or far such other ourposus as Iha seniee may requim.
<br /> It is aiso understood dunng Iho 6mo ihat any of ihe water mains may be out ol service by reason of any emergency or improvements authorized �
<br /> by tho DISTRICT,in any sVeot or other!oca6on in which they may bavo heen laid,the DISTRICT wiil nai bo reGuirod to furnish water during
<br /> the progross of such imorowmanis to any consumnr whoso supply may thus bo eu[oB,or he lia6�o for any damages lor its failure to do so.
<br /> (5) That thc DISTRICT shall havo tho right to chango Iho mtes a�any time by Resolution,to tumporanly discontlnue the servico to consumers,and
<br /> toinstallihomotnr(s) toregistcrthewa[erconsumed. ThoDISTRICTshailnotboheldtiabloford:unagobywaterorothercausorosullingfram
<br /> dofecfivo plumhing ar appliances installed by thn o�mer oraccupant on tho premises supplied with water,and tho fact th�W genis cl ihe D ISTRI CT
<br /> may ha�o inspected tho plumbing and appliances shall not bo pload as a basis lor recovory in caso of damago as aforesaid. If tho supply ol
<br /> water sh all f�il or be intarruptad by reeson ol accidsnt,low prossuro or othnrca��so whatsoover,tho DISTRICT shall not 6e heid 1ia610 tor damages
<br /> nor shall such failuro o�interruption for any roaso�aa6lo lime bo held tu constitulo a 6reach of contract on Iho part of tho DISTRICTor in any way
<br /> raliovo tlia cansumor,whether Ienant or owner,from pedorming ihe obligaGon of such tananPs ar owner's contmct. Water shall be used hy
<br /> � applicant anly on tho promises desui6od horein. A now applica6on shall be filed should water 6o dosirod lor olher premisos alih�ugh located
<br /> � on land described herein.
<br /> iNt (6) Thot tho DISTHICT recommends Installaqan of a preesum regulating valve. Appiicant acknowiedges Informatlon as to �he
<br /> recomme�datlon and assumes full responsibllity lor Inatulling or Inlling to Install n preasure regulaling value on thn wator system to
<br /> /��--+ protect It from high pressure.
<br /> wi (7) The DISTRICT utllizes check velvos el Iho mnter to pmvonl wnter ret�rning to the Olstdcts mn!ns. The DISTRICT recommends
<br /> ��l instullatlono(athnrmalexpanslontanktoprnventexcusslvepressurobulld-upcausodbythewelerheater. Applicantsacknawledges
<br /> � Inlarmatlon as to�h�o rocomI �m�,endatlon and assumes full roeponslhilty lor Installing or Iolling to Install a lhermal expanslan tank.
<br /> I� SERVICE,t,ADDRESS: IOV:.II f�YJ�Ii. �r, LOTNO. A n^ f� p BLOCK
<br /> �J� � PLATNAME: I\�L�I..IJ�"� ��OUCi
<br /> CITY/STATEI :� �� � �� ��i �/v1��� �� � �U LEGAL DESCRIPTION: �C ' I
<br /> � OWNER'S NAME: L�Q Y✓(.� IT C�O1
<br /> �OWNER'S ADDRESS: U l..A� I�
<br /> CITYlSTATE/ZIP: �-��' �u -�� �
<br /> Tho premises aro to bo used as a �� 1 Q,�� I�(,�
<br /> INFORMATION LETTER-GAVE/SENT: �
<br /> CHARGES: In
<br /> (1)Scrvice inst�llation&connection chargo $ �h�' I`�'
<br /> � (2)Goneral Fadlitios connocGon chargo 5 ` b `� ' �
<br /> (3)Other $ �� ��
<br /> To�al amount received with applipUon $
<br /> IT IS UNDERSTCOD that this Applira6ort,althouc�h signed,eJiall nat bo 6indng upon tho MUKILTEO WATER DISTRICT un61 approv;d h,ya a DISTRICT.
<br /> I,tho undersignod,ownar(or reprosontaGve)of tho property dnscribod abovo,do horaby make applicaGon lor insL�IlaGan oF a � � -inch �
<br /> diamoter watoy�ypWyjp rvico connectlon,indu ' g appun�ancos,and all ne ry labor at my oxponses.
<br /> Daled this ��day ol T �» ,is_]�f� .
<br /> APPLICANTS SIGNATURE: ' /^�''-�"�� ��t,� ���'���`�'T�
<br /> . -� i ApplicanCs Namo(ploaso prinq: �K.�U�'��j�"� ��•T ?' � q P�D
<br /> �� ApplicanCs Addross and Phone Number: N' ' '�`�� �3v ;J FL�-C'VUF IQ /%G�G/
<br /> APPROVED:
<br /> �'S5•2Sa� FEB 1 31997
<br /> MUKILT TER DISTRICT
<br /> /, MUKILTEO WATER DISTRICT
<br /> gy. ,� S /�` Date: Z /.� 97 �
<br /> � � - - -n�.. .,rt��eni-�.R"iF i .r'�'^.'-'^+A�.i , _,
<br /> Y � �' tR�71�1�1 , �� w;. ;I
<br /> $ �sa
<br /> _ �'�_�4
<br />
|