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^ - �' � �_i MUKILTEO WATER DISTRICT �' � �
<br /> SNOHOMISH COUNTY WASHINGTON � �
<br /> " �1 U
<br /> APPLIC,4TION �OR WATER / ,� 'n
<br /> V�� 1L
<br /> ipplication No. �� No. ' J
<br /> P.leter Size ��-�% Number of Units 1 Accounl No. O����T / v� �
<br /> I hereby apply tor water service and agree to be gcaemed in accordance with the resolutions, rules and regulations of the �
<br /> NUKILTEO WATER DISTRICT pertaining to water servir.e, now or hereaiter in ef(ecL The undersigned as owner or �
<br /> representative of the herein described prenises hereby agrees as follows: /�
<br /> (t) That tho cost of any extonsion of the water service,renewal,replaxment or repair to reach and serve the pmperry described shall be bome � G/
<br /> 6y myself or assigns as owner(,) of the premises. /�
<br /> (2) That all pipes,water measuring devices;,nd cther connecting equipment upstmam from the mororshall,aherLheir installation,be and become ��
<br /> ihe properry of Ihe MUKILTEO WATER CISTRICT, swjoct to all its re�ula!ions pertaining to water servicQ. �
<br /> �3) 7hat alter installation,if ineler or mrtor box and appurtonws aro buried or damaqed,the owner,will be held responsible and charged far same.;
<br /> (4) That the MU KI LTEO WATER DISTRICT,its offiwrs and agonts,shall have tho right ot ingmss and egress!o go upon the premises and properry
<br /> described hmein for ihe purpose o(inspection,eonnocting or disconnoc6ng the sorvice or lor such other purposos as th^service may requi{e.
<br /> Itisalsounderstooddurinc�Ihotimethatanyolthewatormainsmaybeoutolservicebyreasonofanyemergencyorimprovementsauihorized '
<br /> by the DISTRICT,in any sVeet or clher bcation in which ihay may havo been laid,Iho DISTRICT will not be required to fumish water durinq �
<br /> the progross ot such improeements to any consumar whase supply may thus be wt ofl,or be liable!or any damagos br ils faih�re ro do se.
<br /> (>) That tho DISTRICT shall have the ri�ht m chan�e ihe rates at any time by Resclution,to torcporarily discontinuo tho sorvice to consumers,and
<br /> to install tho meter(s) to register the water consumed. Tha DISTRICT shall not be hold liablo tor damagc by water or other cause rosulting from
<br /> , dofoctiveplumbingorappliancesinstalledbytheowoeroroccupantonthepromisessuppliedwilhwater,and�h3fac,thata9entso(theDISTRICT
<br /> may have inspected Ihe plumbing and appliancos shall not be pload as a basis for rewvery in case of damage as aforesaid. II tho s�pply o!
<br /> w,iter shall fail or be iMermpted by rea�on of accident,low pressure or othor cause what,oever,the DISTPICT shall not be held liable for damag es
<br /> nor shall such failure or interruption br an�roasonable lime bo held m eonstituto a breach of mntract on the part of tne DISTRICT or in any way
<br /> raliovo tho consumer,whether tr:nan�o�awner, �mm pedorming ffio obligation af such tananPs or owner'e contract. VJater shall be used ty
<br /> applicant orly qn iho picmisr.described herein. A new applicauon shail ba filed should water be dosired for ather promises although located
<br /> on land described hcrein.
<br /> i�,; ^�� 6) Th�t the DISTRICT rerommends Inslallallon of a pressuro regulnting valve. AppllcTnt acknowledges Intonnation ee to Ihe .
<br /> `�` recommende�lon and assumes full responslbllity(or installing or fsiling to Install a pressure regulaling value on the vra�er sy�tem lo
<br /> I ' prolecl It�rom hioh pressure.
<br /> ��xr ��11�(7) Thu DISTRICT utllizes check valves �t �ho meter to prevenl water returning to the Distdcts malns. The DISTRICT recommends
<br /> `� installoUonofathermalezpansiontunk�opreventexcessivepressurebuild-upeausedbythewuterhenter. Applicanisacknowledges
<br /> ` Information as to�ho recommendalion and essumes full responsl6fity Ior InsWiling or(alling m Install a thermal expanslon�ank.
<br /> SGRVICE ADDRESS: ��r"'�_�_,=- /i� � � � LOT NO. ,�_;���_ BLOCK -L
<br /> --T �
<br /> -- � PLAT NAME: ���T+�:;.�,� �.- ,,�",�
<br /> CITVlSTATE/ZIP: i'� ,- �-J �� ��'�O� �' ' LEGAL DFSCRIPTIOIJ:
<br /> �T;. � � � J� /�,J�"J'�L .
<br /> ON'NER'S NAME: � 1� �- '- R � �.
<br /> ✓.Ju��i=. ,ii,3��_/��Y� -
<br /> oIVNER'S ADDFlESS: ��,'�G �y �.''�� y- `..` ' _ ,
<br /> CITI7STATE'ZIP: _ . �r,ir:.t�:�� -����z ,
<br /> Thr,premises are to bo used as a _ -
<br /> " ---- � �— '—� ' ���� — � INFORMATION LETT'cR-GAVEI;;ENT: ��,�����—
<br /> �. ,�����, _ . , , : �. :�.�.� �� .•: � .
<br />� ;v/ CHARGES: L^^
<br /> (1)Service installation 8 eonnectiou charge 5 �-�' ��
<br /> r�—
<br /> (2�Genoral Facilities connection ehargo 5 '^",- -
<br /> fi (3)Other S
<br /> � Total amou�t received with applieaqon S — �-t C�' �'�
<br /> 171S UNDERSTOOD thatihis Application,although signed,shall not bo binding upon Ihr MUKILTEO WATER DISTRICTunti!approved 6y the DISTRICT.
<br /> I, t�m undersiynad,owner(or represenmtive)a1�he propetly��scribed above,do hereby make applic�tion lor installation ol a �T�% -inch �.--t_.,
<br /> ci:u:ie�er water supply servica eonnec�ion, including apputlonances,ar.d all nocossary labor at my expenses. � �`
<br /> Datedtiiis -+-•�� dayo��,�_',�_.` ^�,19 r.., r��
<br /> -_J �.iJ-•� � i�,`
<br /> n^rLICANTS SIGNATURE: ' 1
<br /> - � ������.� T , ,t /
<br /> �q�plranfs N�me (please print): ��E/�� ^�a�� ��r � rs L� E JLC - PAID k=���
<br /> ��,�t
<br /> . ,�pnli.-an;'s Address and Phone Number: Z f�� 7� ✓/�' ^.- CG � r% _�� i NOV 131989 '���
<br /> APPROVED: —��4tti �-� de ,/ /<J�: �(�l ii`\t
<br /> tJIUKILT w TE� ISTRICT MUKILTEO WATER DI3TRICT �vr�1
<br /> � �
<br /> � ' � �h.,,�� i/ /� �� Es�,�
<br /> `-'�'- `�' � Date:
<br /> � �;.d
<br /> '`n;.
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