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�- - � . .�. � . . - �. . .�Cr . .... .. <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />^lAppiication No. /a No. <br />Meter Size ��f �� Number o( Units _� Account No. <br />� . `.tC-j_,•.._':'J:�1'�'! <br />O <br />l!'' � <br />� <br />/ <br />� <br />•�.� . —. • <br />I hereby apply icr water service and agree to be governed ir. accordance with the resolulions, rules and regulations oi the <br />MUKILTEO-WATER DISTRICT pertaining to water servi;e, now or hereafter in etfect. The undersigned as owner or <br />representative of ihe herein-described premises hereby agi :es as follows: <br />(1) That the cost of any exlension of Iho water servicq renowal, replawmenl or repair ro raach and serve the properry doscri6ed shail be bome <br />6y myse�f or assigns as owner (s) of the premises. <br />(2) That;Jl pipes, water measuring dovices and otherconnecting oquipmont upstream imm the moler shall, aftertheir installation, be and bewme <br />the prapa;� ol the MUKILTEO WATER DISTRICT, subjact to all its regulations penaining to water service. <br />(3) Thatatterinstallalion,ifmoterormetorboxandappunoncosaroburiodordamaged,thoowner,willbeheldresponsiblQandchargedicrsame. <br />(4) Tha; �ho MUKILTEO WATER DISTRICT, its officcrs and agoms, shall have tho right of ingmss and egmss to go upon the promises and properry <br />described herein for the purpcse of inspectian, connocting or dxonnoctlng the sorviw or for such other purposes as the service may require. <br />It is also undcrstood during thc time that any of ine water mains may bo out ot serviee by reason of any emergency or improvements authorized <br />hy the DISTFiICT, in any si,roet or other location in which thoy may have boen laid, the DISTRICT will not be required to fumich water during <br />Ihe progress ot such improvemonts lo any consumer whose supply may thus be cut off, or bo liable for any damagas for its failuro to do so. <br />�,5) Tha! iho DISTRICT shall haw the ri�ht to chango the ralos at any Iime by Rosolution, to tamporarity discontinue iho sorvice to consume�s, r.od <br />toinstallihomotr.r(s) torr.yis�erihewalerconsumad. ThoDISTRICTshallnotbohaldliablefordamagebywaterorothercausere�::iungfrom <br />delective plumbing or applianxs installGd py theownor orocwpant on the premises supplied with water, and Iho fact that aacr,:� ot the DISTRICT <br />may havo inspocled the plum6ing and'apPliances shall not be pload as a basis for recovery in case of dama�o as aforosaid. It Ihe supply of <br />watcr shall tail or bc intcrrupted 6y roason ol accident, loWpressyra or othor causc whatsoevor, tho DISTRICT shall not he held liable f or damages <br />nar shall such failure or interruption lorany roasonahleyme 6'C'IIeld to eons�iiute a 6reach ot wntract on ihe part of iho DISTRICT or in any way <br />mlieve tho consumer, whathm tonant or owner, from �pedorming Iho :�bligation ol such tonanPs or owner's coniroct. Wator shall be used by <br />applicanl only on the premises doscri6ed herein. A ne �p�licalior, shall be liled should wator 6o desirod lor other promises although localed <br />on land clesuibed herein. �� <br />iN� �) Thnt the DISTRICT reeommends Instnllotfon ot e pressure reguleling velve. Appllcant ucknowledges Iniormation ns to the <br />,,��d recammendetion and assumes full responslbllity�6r Instajling or lelling to Instell a pressure reguluting valuc on ihe water syslem to <br />. y[N✓ pro�ect il from high pressuta �� <br />�r:r �J�� (7) The DISTRICT ulllizes chccl; ��aives at the meicr to,prevenl waler returning lo Ihe Distrfcts malns. The DISTRICT recommends <br />l-. In stnllation ol a lhermai ezpanslon tonk lo prevent exeesalve presaure bulld•up caused by Ihe water heeler. Applicants aeknowledges <br />�\ � Inlormatlon es to thn recommendntlon and essumes lull responsibllty lor Inslalling or fnlling to Install a thermal e:panslon tank. <br />~ SERVICEADDRESS: ��%�� ~�/•�'�:7" �.-�� P�ATNAME: �Y.i-�� '� � <br />CITY/STATE/ZIP; , _':�� ✓'✓ ,J/ � -�i� �" jS % � �� LEGAL DESCRIPTION: � .� % <br />� y / a.- <br />OWN'cR'S NAME/�''�� - [.%f!✓/ �1 �/l <br />OWNER'S <br />� � <br />Thc premises are to he used ns a <br />�_ <br />_�'-'�-✓�„�i',(i �Yi�`�+:.�/� <br />- � INFORMATION LETfeR-GAVe"/SENT: �/�S <br />� CHARGES: <br />(1) Service insiallalion & connection eharge <br />(2) Genoral Facilitios connoction chargo <br />�%�l/. (�� :i <br />�����/. !�� <br />(3) Olher ... � ^ g <br />,'FoWI amopnt�reccived with applicatiqr� 5 � � �� � � G ~� <br />IT IS UNDERSTOOD that this Application, althongli signed, shall notbe 6inding upon ihe MUKILTEO WATER DISTRICT until approvod4r the DISTRICT. <br />I, Oic undcrsi�ned, owncr (or representmive) ol thc property described abovc, do hcreby mako appliwtion lor inslallation ol a� � <br />�j�� -inch <br />diameler waler sypp ty servica connection, in-ludmg appunenances, and aIl nececsary labor at my oxpenses. ' <br />Dated this �-/ day ot Q���„r,� .ig �! � P� TT <br />. 7__ 1/ �i ��- ' ',��+- <br />APPLICANT'S SIGNATURE: A ��'� � /�-tr---•- `ui' <br />ApplicanPs Name (pleaso print): T � � � �� L � /✓ <br />;_ <br />_� Applic�nCs Address and Phone Number. �. ��-'��� �%-- <br />APPROVE _ � J-� /I��l <br />MUKIL�I�AT R DISTRICT —,�� <br />G � �- <br />9���� Date: ✓ <br />AUG 0 4 �993 <br />MUKILTfO WqTER DISTR <br />