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<br /> ) ���� � �1 MUK�LTEO W'ATER DISTRICT " �
<br /> - ' SNOHOMiSrI CCUNTY WpSHINGT0IJ
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<br /> APPLICATION FOR WA�TE�R' �� �' ' �
<br /> ^ application No. !� � — No• �
<br /> Meter Size _'� � "� Number of Units �_ __ Account No. �c2=�- -�TS<�?,�ZO
<br /> I hereby apply for water service and agree to he governed in accordance wilh the resolutions, rules and regulatior:s of the ,�
<br /> MUKI'_TEO WATER DISTRICT pertaining to water service, now or hereafler in eftect. The undersigned as owner or ��
<br /> repres6ratative of the herein-described premises hereby agrees as follows: �
<br /> (1) Tha[the cost of any extension of the water sorvice,renewal,replacement or repair to reach and cerve Ihe property descriSed shail bo bome `�
<br /> by myself or assi�ns as nwnar(s) of the premis4s. �
<br /> (2) That ali pipes,water measuring devices end otherconnoc6ng equipmont upslream fmm the mot��r shail,after theirinstallation,be and become (�y
<br /> !he property ol the AIUKILTEO VJATER DISTRICT,subject to all its regulations pertaining to wator s�rvice. �
<br /> (3) That after installation,it meter o�me!er boz nnd appunences are buried or damaged,iho ownor,will be held respo r.sible and charged for same.
<br /> (4) That tnc MUKI LTEO WATER DISTRI CT,ils otficors and aaonts,shall have thc right ot irqress and egross to go upon!ho premises and propery
<br /> descri6ed hmein for tno purpose af insper.tion,eonnocting or disconnac6ng iho sarvice or for such other purposo�as�he service may require.
<br /> It is also undersrood during iho time that uny of Ihe walor mainc may he oul of service by roason of any emergency or improvements authorized
<br /> by tho DISTRICT,in any street or other locauon in which Ihey may have been laio,iho DISTRICT will not 6e required to fumish water during
<br /> the progress of such impmvements to any consumerwhose supply may thus be cut olf,or be liahlc for any damages for its tailure tu do so.
<br /> (5) Snat;ho�ISTRICT shall hava the right ro chargo the ratos atany time by Resolution,to tomporarily discontinuo Ihe sorvice to consumers,and
<br /> tomstallthemetcr(s) toregistcr�hewatcrronsumod. ThoDISTRICTshalinottsheldliablefordamagebywaterorothercauscresultingfrom
<br /> �Iefoctive plumbing or appliances instaUed by the cwnor or occupant on the premises supplied with water,and the tac!Ihat agents of the D ISTR!CT
<br /> may have ins{.ected tho plum6ing and appliancos shall not 6e pload as a basis for recovery in case ot damage as aforesaid. If Ihe supply of
<br /> water shail fail or be imenupted by reason ol accident,low pmssure or other rause wFatsoever,tlm DISTRICT shall not be held liabte for damoges
<br /> � nor shall such IaiWre or ir.terruption fur any ro�sonable time be held to constimte a breach o(contract on the part of tho DISTRICT or in any way
<br /> rofnve the wnsumer,whetner Ienant ar olvna,irom padurming�ho ahli�ation of such tenanCs or awner's contract. Wator shall be used by
<br /> applicant oniy on the premises described herein. A new application shall be(iled should water be desired for other premices although located
<br /> on iand Aeseribed hcrein.
<br /> i�;� (6) That the DISTRICT recommends Instailation ot a pressuro regulating valve, Appllcant acknowledges InformaUon ac to lhe
<br /> � - recommendmion and ussumes lull responsibllity for Installing or failing to Insloli e pressure regulating value on�he wotcr syslem ic
<br /> protectltfrom high pres,ure.
<br /> i,��; �_(7) The DISTRICT ulllizac check valves nt the meter to prevent w,^.ler rewming to tho Districts malns. The DISTRICT recommends
<br /> - � ' installatlonofathermalezpnnsfonlnnklopreventexcesslvepressurebulld-upcou�edhythewntenc�oter. Applicantsacknowledges
<br /> � I Inlormatlon us�u tho recommendntion and nssumes tull responslblity for Installfng or folling to instoll e ihermai ecpan$lon tenk. '
<br /> SERVICE ADDRESS: ����yn,_���. ��i� LGf NO. _ BLOCK Ov2�__�_'s"'_
<br /> PLAT NAME:
<br /> CITY/STATE/ZIP: �ie�J"��1�����-� LEGAL DESCRIPTION: "�
<br /> OWtdER'S NAME: �i„q_��(��/z,/,_T;��/1� /
<br /> .� - �' i
<br /> OWh7ER'S ADDFESS: �(LL���!/��Jl,P, —
<br /> CITYlSTATc/ZIP: �['i(L��('��"/ 6�/�A qs/7 �IT_.
<br /> The premises ere to be used as a <��(��L�T�E' l(��`�
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<br /> _ INFORMATION LETTER-GAVErSENT.��,'—_
<br /> CHARGES: � -
<br /> (t)Service installation& wnnection charge S -��� �
<br /> (2)Genoral Facilities connoction charge 5 ?,Tj /"'J
<br /> (3)O�har 5
<br /> Tolal amount received with appliwtion S � � ��' �� " i
<br /> �,
<br /> IT IS UNDERSTOOD tnat this Application,although signad,shall nat be binding upon the MUKILTEO WATER DISTRICT un;il approved by ihe DISTRICT.
<br /> I, �iie und�rsiyned,owner(or represenWtive)ol tho property describod nbove,do hereby make application lor installation of a mch
<br /> diameier waror supply servica connoc6on,including appunonances,wd all necessary labor at my exponsos. P �TT
<br /> Dated this day ol ,19 s'S1L
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<br /> APPLICANT'S SIGNATURE: , "�7� � MAY 111990
<br /> ApplicanPs Name(piease prir!): . , " ,
<br /> ��_..'.pplicanCs Address and f`hone Number: ' ; ��.'�� MUKILTEO WATER DISTRICT
<br /> APPROVE�: �—.—�' .o;'� . ,'.'� -�.r `�r`- 5�d87
<br /> MUKILTEO�VATEF{ DISTRICT �
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