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<br /> MUKILTEO WATER DISTRICT v
<br /> SNQHONIISH COUNTY WASHINGTON �
<br /> , AP?LICATION FOR WATER C
<br /> ApplicationNo. _ �� (�i�0
<br /> No. �.��/�/6 �
<br /> MeterSize - � °
<br /> Number of Units _�_ Account No. ��5a5'�v �
<br /> I hereby apply for water service and agree to be governed in accordance witn the resolutions, rules and regulations ot ihe 1
<br /> PI,Uf<I!.TEO VJATER DISTRICT pertaining to water service, now or hereaiter in eifect. The undersigned as owner or l!
<br /> representative of ihe herein-described premises hereby agrees as follof�s: �
<br /> (t) That the wst of any extension ot the water service,renewal,replacement or repair lo reach and serve ihe properry descri6cd shcll be borne V
<br /> by mysell or assigns as owncr(s) of the premises. C
<br /> (2) Tha:all pipe,,water measuring duvices and ntherconnacting equipment upctrnam from the moter shall,afroriheir installation,6e and become C
<br /> t!m pmperry af ihe MUKILTEO WATER DISTRICT, subject ro ail its regulations pr.rtaining to water service.
<br /> (3) Thatafteri�stallation,i�meterormeterboxandappunencesaroburiedordareaged,theowner,willbeheldresponsibleandchargedforsame.
<br /> (G) ThattheMUKILTEOWATER0ISTRICf,itsofficersandagents,shallhavethorightafingressandegresstogouponthepremisesandpmpeny
<br /> described herein lor�he purpuse of inspection,wnnocting or disconneeting the sorvice or lor such other purposes as the serviee may reGuire.
<br /> It is also understood during�he time that any of the water mains may bo out ol service by reason of any emergency or impmvemenis au�horized
<br /> by ihe DISTRICT,in any sveet ar other location in which they may have been laid,ihe DISTRICT will not be required to fumish water during
<br /> Ihr.progmss of such improvon�ents to any consumor whose supply may thus 6o cut off,or be!iabl�for any dama�es for its faiWre to do so.
<br /> (5) That the DIS7RIGT shail have iho right to changa the ratos atany time by Resolution,m temporarily discontinue the servico to ccnsumers,and
<br /> toinstallthemeter(s) torec�islorihewaterconsumed. TheDISTAICTshallnot6eheldliahlefordamagebywa;erorothurcauceresultingfrom
<br /> defective plumbing or appliancn.s installed hy the owner or occupant on tl�e premises supplied with water,and the fact ihatagenis of the D ISTRI CT
<br /> may have inspected ihe pium6ing and appliances shull not Ge plead as a basis for recovery in oase of damage as aloresaid. II the supply ef
<br /> wnter shall Iaii or 6e intermpted by reasan of accident,low pressure or other cause whatsoever,tha DISTRICT shall not be held liablu for damogec
<br /> norshallsuchfaiWreorintermptionloranyroasowbletimB,l�'e �' oconstiWtea6reachofcontractonthepartoltheDISTHICTorinanyv:ay
<br /> re6eve Iho consumer,whether tenant or ownor,L•om polfor��"tBa obligation ol such tenanPs or owner's contracL Water shall be used hy
<br /> , � applicant only on ihe premises described herein. A new `pP�i�t�an shall be tilad should water bo desired lo�other premises although located
<br /> � on land doscribed hcrcin. �.. �
<br /> u;r _ (6) That Ihr DISTRICT recommcnds Inslailotlon of a pressure regulaling valve. ppplicant ucknowledge� in(ormation as to the
<br /> � recommendnllon and nssumes tull responsiblllty for ins�allinp or lalling 10 Inslall o pres,ure regulating value on�he watcr nyslem to
<br /> L}J prolect It from high pressure.
<br /> Inr,fiL._(7) TFe �ISTRICT u�ilizes check valves at Ihe meter to prevenl water rclurNng lo the Districts malns. The DlSTFICT recommends
<br /> ,- - irstallmlonolathermalexpansiontanktoprevenlexce,sivepressurobulld-upcausedbythewaterheater. Applicantsackieo�viedges
<br /> . Informat:on as Io the recommendnllon and nscumec tull rosponslbfity(or Installing or talling pto install a thermol expanslon tank.
<br /> SERVICEhD�JRESS: �/I -�i/;'� ��)��,/J/ ,//J/U� LOTNO. _I'�� ��� [� /•/'�� BLOGK
<br /> . _ L7/�c"% it/A �!�-�G�/ PLAT NAME: —
<br /> CITY/STATE/ZIP: LEGAL DESCRIPTION: L��/�X F/EL /j DO `Z
<br /> OWNER'SNAME: �OII':)� !/�'/7?Giii/C �
<br /> O�VNER'SADDR'cSS: �� /?X I�/C,�IU� �,{T ��jL,/
<br /> GTY/STATE/ZIP: �A('(J'� (,�CI �'� �///
<br /> Thr,premis�s are lo be used as a
<br />� —=� �:�i':.�'� �`i%%n�.
<br /> INFORMATION LETTER-G;,\�FicENT: �
<br /> - � CHAFGES: i`.�� ��I➢----
<br /> ' ��`�, 3� ' 0 1995
<br /> O Cervice instailation&connection char�e s DEi. �J
<br /> z L/ 7.77. 0 'v
<br /> O General Facilities connectian eharge y
<br /> �s�omor y ��UKILTeU INATER �ISTRICT
<br /> Total amount received with appiicaGon $ J J�5. � ✓
<br /> IT IS UNDERSTOOD that this Applicalion,although signed,shail n �c�bin in upon ihc MUKILTEO WATER DISTRICT umil a
<br /> �,�.���Q pP:oved by Ihe DIS7RICT.
<br /> I,the undersigned,owner(or representative)o�the property dascriSed a6ove,do hereby make application lor inslallation of a � _inch
<br /> diameter water supp servico connOction,includi�g appurtenances,and911 r,�c'e1ssary labor at my expenses.
<br /> Datedthis �' dayof:��. ,(Jj%y7/:/�-`K. �7
<br /> i
<br /> `_' \ �'--n J
<br /> APPLICANT'S SIGNATUR� �� •���'�1-i� � _
<br /> Appl��anf'sName�pleaseprint): ! Ap'�� ' ��l'�/���.J?.T,
<br /> _. � An?licanfs Address and Phone Number: •�U �Z— �[�,y.� �� � C�C.�y
<br /> APPROVE : J �� • �7= . Z 15 3
<br /> �4UKI / T�J DISTRICT
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