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� _ 4 . <br /> " TAUKILTEO WATER DISTRICT \ <br /> SNOHOMISH COUNTY WASHINGTON <br /> ' APP!ICATION FOfl WATER 1� <br /> Application No. � I `lv No,�/SO�Os� - <br /> Meter Size v�� �� ' Number of Units � Account Na � �C 'I�7�I U�JO � <br /> I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations of ihA � <br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereatter in efiect. The ur,dersigned a; owner or � <br /> representa'ive oi ihe herein-described premises hereby agrees as toliows: � <br /> (1) That the cost of any extension of tho water service,renewal, replaxment or repair to reach and serva the prop,:h;.'r.n..�in;�;1 shall be bome � <br /> by myself or assigns as owner(s) of ffie premises. <br /> (2) That all pipes,v.ater measuring dovices and ctherconnec6ng eGuipment upstream from the moter shall,afterthoirmstallation, be and bewme ( <br /> the pmporty ot he MUKILTcO WATER DISTRICT, su6ject to ail its regma5ons penaining to water service. S <br /> (3) Thata(terinsta!ation,iFmeterermeterboxandappurtonwsareounedordamaged,theowner,willboneldresponsiblaandchargedforsame. <br /> (4) ThattheMUKILTEOWATERDISTRICT,itsofficersandagonts,shallhavo�herightatingmssandegressrogouponthapremisesandproperty � <br /> descnbod heroin for the purpose of inspection,connecting or disconnoc6ng Iho sorvice or for such olhor purpos=s as Ihe service may reGuire. <br /> i[is also understood dunng tho timo ffidt any at the water mains may he out of service by rea•.on of any emergency or improvements aulhorized <br /> by the DISTRICT,in ary streot ar other location in which they may have been laid,tho DISTRiCT will nat be required to furnish water during <br /> the progross of such improvemonls to any consumer whose supply may thus bo cut off,or be liable for any damages for its faiWm ro do so. <br /> (5) That tho DISTRICT snall havo tho right to chango�ho ratos al any time by Resolution,to tomporanly disconunca�Jio sorvico to consumers,and <br /> toinstallthomoter(s) toregi,torthewaterc�.�sumed. ThaDISTqICTshallno�ooholdliahlelordamagobywatarorothercausaresul6ngfrom <br /> dofoctivo plumbing or appliances installed by tho owner or occupant on tho promises suppliod with water,and iha fact ihat agenis cf tha D ISTRI CT <br /> may have inspectod tho p�umbing and appliances shall noi be p!aad as a basis for rocovory in caso of damage as aforesaid. It tho supply of <br /> water shall fail or bo intorrup'r.d by reason ot accident,low pmssuro or other causo whatsoevor,the DISTRICT shall not bo held liahlo for damages <br /> nor shall such failuro or iNerv�t:un for any masona6io timo bo held to constitute a hreach of wntract on the pnrt of tha CISTRICT or in any way <br /> ,-�_ reliovo tho wnsumor,whothor tenant or ownor, fmm pedorming ihe obligaGon ol such tenanfs or owners contract. Water shall 6e used by- <br /> �� pplicant onty on the promises�ascnbed iiarein. A new applicaGon snall bo fded should watcr bo dosired for ather pmmisas aithough located' <br /> on land desu i6ed hereir.. <br /> y- 6) ThnC�he DIS7RICT recommends Installnllon of a pressura regulating volve. Applicant aoknowledges Infarmatlon as to �he <br /> recommendotlon and assumes full responslblllty tor Installing or fniling lo Install a pressure reguialing value on the watur syslem to <br /> p;otect It from high pressure. <br /> �vr (7) Tho DISTRICT ulillzes check vnlves at �he meter to prevon� walor relurning to the Dls�ric�s malns. Tho �ISTRIC7 recommends <br /> \ Installatlonolathermalexpansloninnktopreventexcesslveprassure6uild-upeaused6ythown�erhealer. Appllcantsacknowlod�os <br /> inlormntlan as to tha rocommendntion and assumes�ull respanslbilly for Installing or falline lo Ins�ell n lhermal expenslon tank. <br /> �/ SERVICE ADDRESS: �'� � � � N G I I L� �T LOT NO. I� BLOCK '� <br /> �' � � _- <br /> PLAT NAME: 1��'��_�_ � l:_ I�� _:._ J �: �K l L � � �I <br /> CITY/STATE/ZIP: � � � �r��� -� V aO � LEGAL DESCRIPTION: <br /> OVVIJEfl'S �AME: ���-`-' ��C. /� ��i�� �I !c°� <br /> OWPIER'SADORESS�3�l3� -G/a�;;; � uk f� ✓ '-� <br /> CITY/STATE/ZIP: ��'lr wa ����5 <br /> .� Tho promises am to bo used as a <br /> t..:l i ���� �L� �`C.c 1 1il/�� <br /> V <br />. <br /> — INFORMATICN LETiEF-GAVFJSENT: <br /> CHARGES: <br /> (7J Sorvico insWilaiion 8 connection chargo $ <br /> i � � a . �� <br /> (2)Genoral Fedlitias connactian chargo $ � � � �' �--'� <br /> (3)Othor $ <br /> Total amount roceived with applicaGon 3 J � '��' �'�''�T'� <br /> IT IS UNDERSTOCD th�t this Application,althou9h signad,shall no16o bindng upon tho MUKILTEO WATER CISTRICT until approvod py�e DISTRICT. <br /> I, tho'undersigned,ownor(or roprasema' ' ho pro y scnbod ubova,do bereby make applicaoon foi installaGon ol a / � -inch <br /> diamotor water su p��servico con on,,ncl in �u�rtp nces,and all n c sa !abor at my exponsas. <br /> Dated�ihis. 9� day6 v �' , - �v� <br /> f '� � <br /> APPLIC'ANTS 5!GNATURE: <br /> � �`�" �,n.a:.u% L'. F� ! I-t �� <br /> AppliwnPs Name (ploasa prinl�: P�� <br /> �-' Appliwnt's Address and Phono Numbar. �L+ �� �� ti.0�� c r Yr�� � � ✓ ;� � <br /> APPRO �_t�-� l�i:'Ti.�+'�",r,., f�iiS 7ro 1 '1�2 `�? 7�-J7�'1 OCT O � 2OO{� <br /> ':n- <br /> MUK! � /tS WATER DISTRICT =' ' ` ' ; `, .' % %� ' <br /> �//.�:�L-.�-. �,;�'o� MUKICTED 'NATER DISTRICT <br /> av/ — ����: — <br /> f C �`*�_.�..�����.....� <br />�— <br />