|
i��
<br /> i�C�{�'�'�+„�-ar�rr3�i:u°,..RR.T�S�.-%�"""'-m�`..–"'–.,.�-.,-._.., . _ ,..4•x�,_ , .. . . .. __.._,,.r•,�nt__.. _.__
<br /> / �l
<br /> � NUKILTEO WATER DISTRICT C,
<br /> ���
<br /> SNOHGMISH COUNTY WASHINGTON �
<br /> •, APpLICATION FOR �NATER �
<br /> Application No. �� 1� NO� �J/ �
<br /> t✓�eler Size ' � � � Number of Units _ � Account No. G�n— /7.�%�5_ ,�,�
<br /> I hereby apply for water service and agree to be govemed in accordance with the resolutions, rules and regulations of the ��
<br /> tv1UKILTEO 6NATER DISTRICT pertaining ;o water service, now or hereatter in eftect. The undsrsigned as owner or �
<br /> represemative of the herein-described premises hereby agrees as toltov;s:
<br /> (1) That tho cost of any extension of lhe water service,renewal,replacement or reyair to reach and servo the properry describod shall be borno �
<br /> by mysel(or assigns as owner(s) of the premises.
<br /> (2) 7natall pipos,wa:cr measuring dovices and other connocting equipment upstroam from tho matar shall,afterthoir installaGon,bo and become �
<br /> the property of the MUKILTEO WATER DISTRICT,subjoct to all its regulafions pottsiring to water service.
<br /> (3) That alter installation,if ineter or meter boz and appuKoncos are buriad or damaged,lhe cwnor,wili bo hold responsihle and chargad tor same. �,
<br /> (4) That Iho MUKILTEO WATER DISTRICT,its o(firArs and agints,shail have Iho right ot ingress and agress to go upon iho prcmises and propErty rn
<br /> describod heroin for the purposo ol inspoction,connocting ur discom�cting Iho sarr.ce or for such other purposes as tho sanico may require. v�
<br /> li.s also understood during thn time that any of tho water mains may be out ot service by reason ol any emergenry or improvements aulhorized
<br /> . by Ihe DISTRICT,in any street or othor location in which thay may havo beon laid,tho DISTRICT wili not be required to fumish water during
<br /> the pmaross o�such improvoments to any consumer whoso supply may ihus be cut olf,or be liablo foi any damages for its tailure to do so.
<br /> (5) That the DISTRIGT shail havn tho right ro chango Ihe ratos nt any time by ResoWtion,to tomporerily dlscontinuo tha serviw to cnnsumers,and
<br /> toinstallthemoter(s) toregislerthewaterconsumed. ThoDISTRICTshallnot6eheldliabiefordamagebywatororothe�causaresultir,gfrom
<br /> defoctive plumhing or appliances ins�alled by Ihe ownor or occupanton the premises suppliod with wator,and tho tact Ihat egents of Iho DISTRI CT
<br /> may have inspocted tho plumhing and 2ppiiances shall not be pload as a basis to�recovory in wse of�amage as aforesaid. If;ho supply o!
<br /> woter shall lail or bc inte�Tupted by reeson of accident,low pressuro or olher causo whatscevar,the DISTRICT shall noi be hold liable tor damages
<br /> nor shall such lailure-r interruption lor any roasonable timo bo held to constiNto a breach of contrac[on the part ot iho DISTPoCT or in any way
<br /> roliove tho consumor,whother tonant or owner,trom pedorming Ihe o6liEation of such Ien�nPs or owners contract. Water shall bo usad hy
<br /> (� � applicant only on the promises desaibed horein. A new applicatlon shall 6e filed should water bo dosimd forolher premises allhough locatad
<br /> c � on land descrihod harein.
<br /> iy; j Thnl the DISTRICT rncommends installalion ol u pressura reguleting valve. Applicent acknowledges Informetion us to the
<br /> irecommendellon and ussumes�ull responsiblllty for Installing or tilling lo Inslall e pressure regulating value en thn waler syslem to
<br /> prolec[Ilfrom high pressure.
<br /> i,UT ) The DISTRICT ulllizes check valves al the meler to pravont wotor ro�urning to tho Districts malns. The DISTRICT recommends
<br /> ' � inslnllntlnnofathermnlexpnnslontonklopreventexcessiveprossurebulld•upcauaodhylhowalerheuler. Appllcontsecknowledges
<br /> � nlarmutlon ns to the raaommendntlon and assumos full rosponalbll�y lor Instelling or folling�o Instell e thermal ezpenslon lank.
<br /> SERVICEADDReSS: �//0��� ��'�'A�� f-"�• LOTNO. �� BLO�K
<br /> �(/`;,;.c..c /, / R��:� � l%.!. (�
<br /> -�...:! PLAT NAME: G�.;.C'_... /-�-�'�� � /..,/.
<br /> CITY/STATElZIP: '�'� LEGAL DESCRIPTION: �'I' r '�`��� -
<br /> ON'NcR'S NAM�: �u���� �utii i o�+�uy,Ha,l , l l C -
<br /> OWNER'S ADDRESS: �' �� ��� � ��, .
<br /> CITY/STATE/ZIP' t �(c\"L.^� . WWCtI . �J �i1.�� ' ...
<br /> �
<br /> The premises are to be usfld as a � , ,•.� ��,� � .
<br /> l�� / � � � '''� ' � � INFORMATION LETTER-iAVE/ScNTt t
<br /> CHARGES: � '
<br /> (i)Service instatlation &wnnection charge 5 �'�•C�J �
<br /> y/gp.�� JUL 1 9 2000
<br /> (21 Gcnaral Facilitics connoction charge 5
<br /> (3�oihor 5 y� �J MUKIL7E0 WATER DISTRICT
<br /> Total amount received with application S
<br /> IT IS UNDcRSTOOD Ihat this.4ppiication,although signed,shail no:6o binding upon the MUKILTEO WATER DISTRICT untll approved by the DISTRICT.
<br /> 7
<br /> I, the undersignod, ownar(or re�resonlativo)of the propeny dascribod ebove,Lo heroby make appliwtion for instailafion ot a � � �` -inch
<br /> diamoter wator s�p`p y se�vico eonnection,.inclu�ng appurtona es,and ell ryr.�s;pJy,labor at my ezpenses.
<br /> Dated this aay of ��� � - O�L�='�l
<br /> APPLICANTS SIGNATURE: ��� � � —
<br /> i
<br /> . ApplicanCs Name(pleasvpnc�): ����� \ ��`L��
<br /> `� ApplicanPs Address and Phona Numbec �' J • ��3'' 2��
<br /> APPROVE . E����k 1� , �.1�A �j 1�,2.J�
<br /> MUKIL7 WATER DISTRICT
<br /> i ' /
<br /> �� �' F'�-�.�' Date: ��� `���
<br /> By: � -
<br /> �
<br /> p,
<br /> �
<br /> � �.��:µ.�,. ..-:
<br /> � � �
<br />
|