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' ' � MUKILTEO WATER DISTRICT
<br /> - SNOHOMISH COUNTY WASHINGTON Q
<br /> APPLICATION FOR WATER Q
<br /> �I =�U� `
<br /> Applicai�on No. Na ' �
<br /> Meter Size � ��a2 Number of Units � Account No. �'� �7g � `�3s w
<br /> I hereby apply forwater service and agree to be governed in accordance with the resolutions, rules and regulations o( ihe �
<br /> MUKILTEO WATER DISTHICT pertaining to water service, now or here�(ter in etfect. The undersigned as owner or 1�
<br /> represe�talive of ihe herein-described premises h�,reby agrees as tollows: 5
<br /> (1) Tnat the cest of any extension ot the w�ter sorvice,renewal,replacement or repair ro reach and serve Ihe property described shall be bome �
<br /> by mysotf or assigns as owner(s)�f ihe premises. �
<br /> (2) That all pipo�,water:neasuring dovicos and othar connecting eyuipment upstraam from the me�er shall,aftor thoir installation,6o and 6ewme i�
<br /> the property of the MUKILTEO 1VATEFi DISTRIGT,subject to all its mguiations pertainin�te water service. �
<br /> (3) Tnat alter installation,if ineter or metor hox and apput,onces are buriod or damaged,the owner,will be held rosponsibla and chargod for same.
<br /> (4) ThattheMUKILTEOWATcRDiSTRICT,itsolficersandagonts,shallhaiotheriahtofingrossandograsstogouponthopremisesandproperty �
<br /> describod heroin foriho purpose of inspoction,connocling or disconnocting tho sorvice or for such other pur0oses as the service may require. P,,.
<br /> It i s also understo�d during tho time that any of tho water mains may be out af service by roason of any emergency or improvements aulhorized ����
<br /> by the DISTRICT,in any streot or other localion in which they may have been laid,ine DISTRICT will not be roquired to fumish water during �
<br /> tho progress ol such improv�monls lo any consumer whose suppl�may thus be cut oH,or ba liablo lor any damagos for its failure to do so.
<br /> (5) Tnat the DISTRICT shail have tho nght to chango ihe ratos at any time hy Fesolution,to tomporan!y discontinue iho sorvico lo consumers,and
<br /> ic install Iho meter(s) to registcr Ihe water consumeC. The DISTRICT shall not be held liable for dama3e 6y water or other wuso resulting from
<br /> dofocfive plumbing or appliances installed by the ownor or occupant on the promisec suppliod with wa[or,and iho fact Ihat agents of the DISTRI CT
<br /> may have inspected tho plumhing and appliances shall not be pload as a hasis tor rocovory in caso of damage as aforesaid. If the supply nt
<br /> water shall fail or be interropted by reason ot accident,low prossuro or other causo whatsoever,the DISTRICT shall nol bo held liablo for damages
<br /> nor shall such lailure or inlermption�orany roasonable timo be held to constiWte a 6reach of eontract on ihe part ol ihe DISTRICT or in any way
<br /> rolieve tho wnsumor,whethor tenan!or ownor,fmm podorming the obligation ol such tenanPs or owners conVact. Water shall be used by
<br /> applicant oniy on the premises described herein. A now epptication shatl bo filod should wator be dosimd for other promises although locatod
<br /> i on land described heroin.
<br /> iy� �( ) Thnt the �ISTRICT recommends InstallaUon of e pressure reguleling vnlve. Applicant acknowledges InformnUon es to Ihe
<br /> recommendellon and nssumes full responslblllty for Installing or fnlling to Instell a prossure regulat(n8 value on Lhe wator system to
<br /> � �1 protect Il�mm hlgh pressure.
<br /> �vr �(7)�The DISTRICT u�llizos r.heck vnlves el the meter to prevonl wnter retuming to Ihe Dlstrfcis malns. The DISTRICT recommends
<br /> In stolla�lon ol a therma I ezpenslon tenk to prevenl ezcessf ve pressuro bulld-up wused by tho walar henter. Applicants acknowledges
<br /> ' Informatlon es to tho rocommendetlon and essumes full rosponslblity for Instelling or�elling to Instoll e thermel expanslon tank.
<br /> � ioy�y !��! '-� G�:. �/d 3
<br /> SERVIG_ ADDRESS: LOT NO. _� � /BLOCK / /
<br /> PLAT NAME: �/�(r�i� i�,lr/�l�f/// /_{;>.
<br /> CITY/STATE/ZIP: iUr��' � � � LEGALDESCRIPTION: '�`��• ��`f�
<br /> OWNER'S NAME: �a'�.� IZuiJ T.Jwti�IV��uI , �� C
<br /> OWNER'SADDRE55: �7' J �'�' ���1
<br /> CITYlSTATE2IP: t��r�k�-" �� �_a ���� (
<br /> Thc promises aro to bo usod as a �7'u'(�'� �m��� ` �
<br /> INFORMATION LETT'eR-GAVc/SENT: � � --
<br /> i
<br /> CHARGES: \/
<br /> (1)Servico installauon&wnneotion charge 5 t5/�/�`�'� JUL 1 9 2000
<br /> (2)Genoral Facilitios connoction charge S J �7,'''��
<br /> �3>otner " y MUKILTEO WATER DISTRICT
<br /> Total amount received wilh applicauon 5 �S/O �',
<br /> IT IS UNDERSTOOD that ihis Appliwtion,although signed,shall not bo binding upon tho tdUKILTeO WATER DISTRICT until approvad by the DISTRICT.
<br /> r �i�
<br /> I, the undorsignod,owner(or represon�ative)of the property dsscribed nbove,do horoby make application for installauon ol a �` -inch
<br /> diamotor wator su p�Y sorvico connection;includi g appurtena ces,snd aIl c ry labor et my oxpenses.
<br /> ` Da[ed this �/ day of "��� �� , - ��
<br /> APPLICANT'S SIGNATURE: � r
<br /> ��A,t� j?F�1C
<br /> . ApplicanPs Name(ploase prinq: ,� —
<br /> �� Appiicanfs Address and Phono Numbor. �'3 ' ?�* L 1�Q1 .
<br /> AFPROVED. L "��=�� .�.il\ �i�24 3 --- --
<br /> MUKILTE,Q�ATER DISTRICT
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