1621 HOLLOW DALE PL 2016-01-01 MF Import

4,� _. ♦ �.1.� ,.:-::..._ ..,._.,.:--.. , , .. ' MUKILTEC) WATER DISTRICT SNOHOMISH COUNTY WASHINGTON APPLICATION FOR WATER ^` � J / ' _ � _ Application No. Meter Size _ ��f� �� Nu �b� �( Units _ � -,,.._ . � ... , . . 0 U � ..0 No 3'��` � Account N�. �� —/7% �6 30 � � � I hereby apply for water service and agree to be governed in accordance wilh the resolutions, rules and regulations oi ihe MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in eftect. The undersigned as owner or representative ot ihe herein-desc.ribed premisrs hereby agrees as follows: (1) That the cost of any extension of the water service, rene•sal, replacement or repair to raach and serve the property described shall be borne by mysclf or assion; as owner (s) of the premises. (2) That ali pipes, water measuring devices and otherconnecling equipmont upstroam from iha moter shall, attertheirinstallation, be and become Rm proporry of Ihc MUKILTEO WATER DiSTRICT, subjoct to all its regulations portaining to water servi:e. (3) That aher installa�ion, if ineter or moter boa and appurtenws a�e buriod or damagod, iho owner, will be hel� respontiblo and charged for same. (4) ThatlheMUKILTe06YATERDISTRICT,itsolliccrsandagenis,shallhavethcrightofingrossandegresstogoupanthopremisesandproperty � described horein br tho purposc ol inspection, connoqing oi disconnocting the sarvi;w or for such other purposos as the service may require. II is also understood during the time that any ol ihe warer mains may be out ol service by reason of any emergency oi improvements authorized � by the DISTFICT, in any street or other location in which they may haw been laid, the DISTRICT will nat be required ro tumish water during the progress ol such impmvemonts ro any consumor whose supply may Ihus be cut ofl, or be liable for any damages for its failure to do so. (5) That the DISTRICT shall have ihe nght to chango the rates at any �ime by Resolution, to temporarily discontinue [ho servico to consumers, and to install the meler (s) ro register Ihe water consumod. The DISTRICT shall not 6e held liablo lor damage hy wa[er orother cause rQsulting irom dofective plumbing or appliances installed hy iha owner orocapant on Ihe premisos supplied with water, and th e faetthat agenls of the DISTRICT may have inspected ihe plumbing and �ppliances shall not bo pload as a basis lor rocovery in case of damage as aloresaid. If �he supply ot water shatl fail or 6c intevupted 6y teason o(accident, low pressure or olhcr causc whatsocvor, ll ie DISTRICT sha�l not be he�d liablc tor damages nor shall such ftilure or interruption lorany reasanable timo be held to constitute a breach of conlract on the part of Iho DISTRICT or in �ny way rolieve the consumer, whelher Ienant or owner, from performing tha obligalion ol such tonanPs or owners eontreet. Wntor shall be used hy applicant only on tho premises descrihed herein. A new application shatl be filed should water bo desimdforo�her prumisos ahhouph Iocaled �� on land desaibed herein. iNt _IJ" i 1 (G) Thnt ihe ��STRICT recommends Installollon ol a�Pressure raguleting valve. Applfaant acknowledges Infatmatlon es to ttie J recommendallon and assumes lull responsibillty for Installing or lelling to install e pre<sure reg�lating value on the weter system to protect It irom high pressura j - iNi ''�� (7) The DISTRICT utilizes check vaWes at iho meler to preveot water reluming to �he Dfsldc�s malns. The DISTRICT recommends ' '-T- insinllalionolathermalexpenslontnnklopreventexcesslvepressurebulld•upceusedbythewalerheater.Applieantsacknowledges iInlormutlon as lo the recommendatlan c:� � assumes (ull responslbllty tor Inslelling or telll to install a Ihermol ezpanslon tank. ScRVICE ADDRESS: �E"oZ I �-loLLr�uiDR[� �G- {,OT NO. � _ BLOCK _ < _ PIAT NAME:� /%.%� ..�r :�L � CI1Y/STATE2IP: 1��0 �� LEGAL DESCRIPTION: _ OWIJER'S NAME: OWNER'S ADDRE CITI'/STATE/ZIP: � � � Thr. pCiises arc to bo usod as a - " v� - ��zf � INFORMA?ION LETTER-GAVE/SENr: ' �? CHARGES: (1) Service installalion & wnnection chare�e S /, `� ' �[/ _ 7f A Tr 9 /G,ZO l�_ •L'lf1L (') Gancral Facilitias eonnection char o 5- ' i c3, omo� '_ :� s / SEP 0 91993 Totnl amoun4 received wilh applicalion 5- �/v'� ' l� � ' UKILTEO WqTER DI��Ri1��T IT IS UNDERSTOOD �hal this Applicalion, although signed, shai6no16e binding upon the MUKILTEO WATEF OIST�iICr untilapprovo�d by` thc I, ihe undersiqned, owner (or representa�ive) of Ihe pmpeny doscribed nbovo, do hereby make appliwtion for instal��aoon ola �( � -inch diamoter watur su service co� ne�Iio 'ntludinp�pp�iqen nces, and911 ne essary labor at my exponsos. �7 Dated this da ol �_ . . _ i 1 . �i�� APPLICANT'S SIGNATURE: Applicant's Name (ple�sc print): _.. � AppiicanYs Address and Phono APPROV D: !i vc�'i /' ��i MUKI , ATER DISTRICT 6�`'��_1�',/� Date: �I� .� . �