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' MUKILTEO WATER DISTRICT �
<br /> SNOHOMISH COUNTY WASHINGTON �
<br /> _ APPLICATION FOR WATER �
<br /> ApplicationNo.' Na ��-�(�J3
<br /> Meter Size 3 �' Number oi Units `_ Account Nu. __��D-/7.�(oa�/p ��
<br /> I hereby apply for water service and agree to be govemed in accordance with the resolutions, rules and regulations oi the �
<br /> Iv1UKILTEO WATER DISTRICT pertaining to water service, now or fiereafter in effact. The undersigned as owner or �
<br /> representative o(the herein-described premises hereby agrees as follows: �
<br /> (1� Tha:the cast of any eaimision of the water service,renewal, replacement or repair to reach and serve the propmry described shali be bome �
<br /> by myself or assigns as owner(s) o'ihe premises. �
<br /> (2) That all pipes,water measuring devices and other connecting equipmont upstream Irom the meter shall,aftm their instaliation,6e and become k..:
<br /> ihe pmperry of the MUKILTEO WATER DISTRICT,subject to all its regulations pertaining to water service. �
<br /> (3) 7hataherinstallation,ifmr.terormeterboaandappurtencesarehuriedordamaged,theowner,willbeheldresponsibieandchargedlorsame. C
<br /> (4) ThattheMlIKILTEOlVq7ERDISTRICT,i�softicersandaponts,shalihavetherightofingressandec�resstogoupor�hepremisesandproperty
<br /> desr.ribed herein for Ihe purpase of inspection,connacting or disconnecting the sorvice or for such other purposes as the service may require.
<br /> It is also undcrstood during the time that any ol the wa�er mains may be out of sernco by reason of any emergency orimpmvements auihorizPd
<br /> by the DISTRICT,in any slreet or othe�location in which Ihey may have heen laid,the DISTRICT will not be required to fumish watcr d�rino
<br /> Ihe pme�ress of such improvements to any con;umer whose suppiy may ihus he cut ol�,or be liablc for any dama�rs�or its failure to do so�
<br /> {5) Tha;tho DISTRICT shaii have tho right to change Ihe rates at any time hy Resolution,to temporarily discantinue the service to consumms,and
<br /> to i nstall the meier(s) to rec�ister the wa!er consumed. The DISTRICT shall not be held liable for damage by water or other cause resutting from
<br /> defective plumbing or appliances installed by Ihe owner or occupant on Ihe premises supplied with water,and Ihe fact that a�ents of Ihe D ISTRI CT
<br /> may have inspected Ihe plum6ing and appliances shall not be plead as a basis lar rocovery in case of damage as aforesaid. If the supply of
<br /> water shall lail or be interrupied 6y reason of accident,low pressure or other cause whatsoever,the DI STRICT sholl net be held 1ia61e for damages
<br /> . nor shall such failure oriNerrup�ion forany reasonable time be held to constitule a breach af wntract on Ih^part ot the DISTRICT or in any way
<br /> relieve the wnsumer,whether lenant ar owner,fmm performing Iho ohligation ol such IenanCs or owner's contract. Water shall be used by
<br /> appliwnt only on the premises descri6ed herein. A new application shall be filed should water 6e desired for other premises alihough located
<br /> c'""`" on land described hcrein. �
<br /> in�; �(6) That Ihe DISTRICT recommends Inslailallon ol o pressure regulating vnlve. Applicant acknowledges Informatfon as to thc
<br /> recommendntion and assumes tull responsibllity for installing or failing to fnsWll a pressurc regulating value on the waler syslem lo
<br /> �, protect It Irom high prescure.
<br /> iri��(7) The DISTRICT utilizes check valves at Ihe meter lo prevent water relurning lo ihe Disiric�s mains. The DISTRICT recommends
<br /> installalion ol a thermal expansion tanA Io prevent ezces,ive pressure 6uild-up eaused by thewaler heater. Applicants acknowledges
<br /> ` ' Inlorma�ion as to the recommendmion and assumes full responslbliry lor Ins�alling or failing to ins�all a thcrmul ezpansion�ank.
<br /> SERVICE ADDRESS: ��_�_�� �, l� (! �i, ,.� LOT NO. � BLOCK I O
<br /> }� PLAT NAIdE: ;�, i- „ . ,, '
<br /> CI7Y/STATE/ZIP: _ ?- 6.r, � j f � �'�. LEGAL DESCRIPTION:
<br /> OWN'cR'S NAME: �, �1�., . r��,� �\ r -x - �
<br /> OWNER'S ADDRESS: ��� , ` \ � i � L S
<br /> CITYlSTATEiZIP�. ��l [� C� S�
<br /> � �
<br /> Thc prr.mises are to be used as a �
<br /> --� " ��=-� ' J \ � i
<br /> _, < INrORMATION LET7eR-GAV't!5'tWT,,=._�,�?"/,��,,, �__
<br /> r�__ �/ �
<br /> CHARGES: /' �
<br /> (1)Service instailation& wnnection charge 5 __��U . �l�
<br /> (2)General Facilities connection charge S �y (" J
<br /> (3)Other �
<br /> Total amount received with appliwtion 5 ����� C7 U
<br /> IT IS UIdDERS'O�D that this Appliw�tion,although signed,shall not 6o binding upon Ihe h1UKILTEO WA7ER DISTRICT unti'�.eparoved by Ihe DISTRICT.
<br /> I, Die undcrsigned, owner(or representative)o(the propeny described above,do hereby make aopli;ation lor installation of a ����
<br /> diamoler�•ater su ly�vice connection,I�ig appunenances,and all n cessary labor at rny expenses. �� �-�nch
<br /> Daied this _��,� day of �- � �g
<br /> � (���'}. �—
<br /> APPLICANT'S SIGNATURE: _ � Yr.� �T b�J'---
<br /> ` �J
<br /> Applicanfs Idame (please prinl):, � I �C� � iOr[1 ��( � l �
<br /> - ApplicanPs Address and Phone Number �,.�;�� � �'� � � �l 5 PAID
<br /> APPROVED: —.,�L C 1� , ,� ,-�c�, -•.ck ^�--3� 1 �
<br /> MUKILTEA VYATER DISTRICT N�AY 16 1991
<br /> gl�� -Yf�-7--�C- Date: � .
<br /> l'
<br /> �1UKILTEO WATER DISTRIC�
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