1710 HOLLOW DALE PL 2018-01-02 MF Import

MUKILTEO WATER DISTRICT SNOHOWSH COI:NTY WASHINGTON �/7J 77 APPLICATION FOR WATER — 34 (� Application No. —�2C 'iv No. Ul Meter Size J�y Number o1 Units Account No. Q_-W — f'I7lcG 4Y I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations of the MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in effect. The undersigned as owner or representative of the herein -described premises hereby agrees as follows: (1) That the cost of any extension of dire water service, renewal, replacement or repair to reach and serve the property described shall be home by myself or assigns as owner (s) of the premises. (2) That al! pipes, water measuring devices and other oonnacung equipment upstream from the moor shall, after their installation. be and become the property of the MUKILTEO WATER DISTRICT, subject to all its regulations pertaining to water service. (3) That after installation, if meter or meter box and apputenoss are buried or darnaged, to owner, will be held responsible and charged for same. (d) That the MUKILTEO WATER DISTRICT, Its officers and agents, shag have the right of ingress and press to go upon the premises and property described herein for the purpose of inspection, eonnoc g of disconnecting the service or for such other purposes as the service may require. It is also understood during the lime that any of M water mains may be out of service by mason of any emergency or improvements authorized by the DISTRICT, in any street or other location in which they may have been laid, the DISTRICT will not be required to furnish water during the progress of such improvements to any consumer whose supply may thus be cot oh, or be fable for any damages for its failure to do so. (5) That the DISTRICT shall have dire right to change tide rates at any time by Resolution, to temporerly discontinue the service to consumers, and to install the meter (s) to register the water consumed. The DISTRICT shall not be held table for damage by water or other cause resulting from defective plumbing or appliances in staffed by the owner or occupant on the premises supplied with water, and the fad that agents of the DISTRICT may have inspected the plumbing and appliances shall not be plead as a basis for recovery in ease of damage as aforesaid. If the supply of water shall fail or be interrupted by reason of accident, low pressure or othercause whatsoever, the DISTRICT shall not be held liable for damages nor shall such failure or interruption for any reasonable time be held to constitute a breach of oorilmV on the pan of the DISTRICT or in any way relieve the consumer, whether tenant or owner, from performing the obligation of such t nam's or owners contract. Water shall be used by applicant only on the premises described herein. A now application shall be filed should water be desired for othw premiws although located on land described herein. (6) That the DISTRICT recommends Installation of a pressure regulating valve. Applicant acknowledges Information as to the recommandation and assumes full responsibility for installing or failing to Installs pressure regulating solution tho water syslom to protect it from high pressure. ikr �v 5. (7) The DISTRICT utilizes check valves at the motor to prevent water returning to the Districts mains. The DISTRICT reeommnds Installation of a thermal expansion tank to prevent excessive pressure build-up caused by dta water Meter. Applicants acknowledges Information as to the recommendation end assumes fug matinslblity for Instafhg or falling to Instal a thermal expansion tank. r., I SERVICE ADDRESS'. I T I D LOT NO. BL K _ PLAT NAME. V u r T CITY/STATE/ZIP: J' dC� LEGAL DESCRIPTION: OWNER'S NAME: L / '1'' 1 OWNER'S ADDRESS: _' V3 1� 3( Y (, W10 — CITV:STATE:ZIP. I T'1 7Vwoi b) V A Wf„ -G. The premises are to be u�od a5 a INFORMATION LETTER-GAVE/SENT: CHARGES: S / (1) Service installation 6 connection charge $ t `) (2) General Facilities connection charge $ (3) Other $ 1 Total amount received with application $ — C' U IT IS UNDERSTOOD that this Application, although signed. shag not be bndng upon the MUKILTEO WATER DISTRICT unfit approved b the DISTRICT. I, the undersigned, owner (or representative) of the property described gpve, do hereby make application for installation of a -ittdt diameter waters I ice connection„ j G p nenances, an al sary labor at my expenses. Dialed this day of APPLICANT'S SIGNATURE =;" ' L, Applicant's Name (please print): � ' k X L `� Ei "1LH L �I✓� �� J .,i Applicants Address and Phone Number: APPROV ',T MUKIL7 O ER DISTRICT By JC7 PAID Date: Or. Z44 MUKILTEO WATER DISTRICT