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J ' ncc:urr �:o�_ �GC ZOL <br /> APPLICATIOhi IJO.____ / G_ . .___ __ _ '''��i`�t--f . . <br /> ``' NiUKILTEO WATE�r2 :�ISTF'iICT <br /> SNOHOMISH COUNTV. WASHINGTON n <br /> yi-- � '. <br /> ApPQ.mCA�'iC�N EO� VIl�"eTER �� '�KURDERNO. �.� —�:��%L <br /> F 'a�Ln -`�S _ <br /> . f <br /> }dukilteo,Washin9�on— �_ / .19P s . <br /> 7'O THE SUPERItv'TENDENT OF THE MUKILTEO \:'ATER DISTr ICT: OR METER CHANGE ONLY <br /> 1 iiereby epply !or ihe use oi waler in accotdance wifh the :ules and regulations o[ <br /> :he hfukilleo Wate:Diatrict. � <br /> During the time ihat any ot the wate: mainn nay be ta'r.^_n up by reason ol any im- �ING _ <br /> p:ovemenl authr.r_ed ay the Disiric! in or o( any street, road or alley in whicn they may <br /> iicve been loi.i, the DisL-ict will not be required lo lurni;h water during the progrecs ol --- <br /> cucn ireprovement� lo any consumer whos_ supply may thus be cut oli, or be liable 'tor . NO. <br /> vny damage fc:iL lailure co to do. <br /> 'Che nu�ner shall be 1ia61c fur any damages to thc scrvicc connection. ,DING <br /> PROPCRTI' DESCRIPTION:��'« � T `" � l�i �/I�� � <br /> NO. __ <br /> _ _ I <br /> REPAIRED ❑ <br /> /Q/� � c��d����_�����r �UiPMENTRENTAL <br /> ADDRESS:_ � NAME COST <br /> Sta;a size o{service `� inch �� �� G�C' <br /> ��?-;, DD has hecn received with Ihi;application. ' ,K <br /> The premices afe fo bc used as a �� �-�/�'�'�� �— ���'�--�-- <br /> �. , � . / � , <br /> ?h�owne:o(tiie premises is '�/�F� es J�/I � '���� <br /> T <br /> in� a9enl is '��%� `'S"�� iOR <br /> Tnc District recommends installation o( a pressure regulating valve. <br /> i�pplicant a:knowledges inlormation as to the recommendation and . . . <br /> Acr^es lo inctall a pressure regulating valve <br /> Signed <br /> TOL1L EOUIP. ��GC <br /> Deolines to install cpres�u{i icgulating volv� <br /> s;���� �/';�. G-r--__� LABOR <br /> -� - cosr <br /> 1! is nndetstood that all connec[iors,including meter and meter boz sltall remain lhe prope[ly of <br /> Atukiltc�atft, s�y ' ,' /'�� r <br /> C'ti� L/ i i � � � �i'1 1`� � �/ G C� <br /> ��I..�_. (,i. 515nc/��:.1� �y�7.�/ , OWRft <br /> r �� ��� <br /> ' ��e� hddress ��� <br /> MUKILTEO WATER �11$�'Y ��(_(,.t,LN _ ��oZ�� Agent <br /> p Address <br /> ' <br /> TOTAL MATERIALS COST /J, /I TOTAL LABOR COST /�� � � <br /> FOF OFFICE USE ONLY: TOTAL CHARGcS _ ��'S'� <br /> DATE COMPLETED ADD� y °o OVERHEAD �• C,�/ <br /> POST TO ACCT NO. ���� �?��•S � TOTAL OVERALL ____���L-- <br /> _ ____ C�STOMER CREDIT _____.—_-- —. <br />