1714 HOLLOW DALE PL 2018-01-02 MF Import

�.1 MUKILTEO WATER DISTRICT SNOHOMISH COUNTY WASO'NGTON APPLICATION FOR WATER Application No. Meter Size Number of Units No.�s = 3yY Account No. 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 the water service, renewal, replacement or repair to reach and serve the property described shall be borne by myself or assigns as owner (s) of the premises. (2) That all pipes, water measuring devices end other connecting equipment upstream from the meter shag, after their installation, be and become the property of the MUKILTEO WATER DISTRICT, subject 10 cog its regulations pertaining to water service. (3) That after insmlation, if meter or meter box and appurlenas are buried or damaged, the owner. will be held responsible and charged for same. (4) That the MUKILTEO WATER DISTRICT, its oNiars and agents, shall have the right of ingress and egress to go upon the premises and property described herein for the purpose of inspection, connecting or 6sanneeting the Service or for such other purposes as the service may require. It is also understood during the time that any of the water mains may be out of service by reason 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 lo furnish water during the progress of such improvements to any consumer whose supply may plea be cut off, or be liable lot any damages for its failure to do so. (5) That the DISTRICT shag have the right to change the rams at any tine by Resolution, to temporarily dkscanbnue de service to consumers, and to install the meter (a) to register the water consumed. The DISTRICT shall not be tell liable for damage by water or other cause resulting from detective plumbing or appliances installed by the owner oroceupaMam the premises wppliedwith water, and the fact thatagents of the DISTRICT may have inspecod the plumbing and appliances shall not be plead as a basis for recovery in case of damage as aforesaid. If the supply of water shah fail or be interrupted by reason of accident, low pressure oroter cause whatsoever, tee DISTRICT shall not be hold liable for damages nor shag such failure or interruption for any reasonable time be held to constitute a breach of contract on the pan of the DISTRICT or in any way relieve the consumer, whether tenant or owner, from performing the obligation of such tenant's or owner's contract. Water shall be used by applicant only on de promises described herein. A new application shag be filed should water be desired for other premises although located on land described herein. S(6) That the DISTRICT recommends Installation of a pressure regulating valve Applicant eeknowladgee Information as to the 7 recommendation and assumes full responsibility for installing or falling to Install a pressure regulatkp value on the wow system to protect it from high pressure. u� (7) The DISTRICT utilizes check valves at the anew to prevent water reWmkq to the Districts mains. The DISTRICT recommends Installation of a thermal expansion tank to present excessive pressure bulW-up amused by the weer Meer. Applicants acknowledges Information as to the recommendation and assumes full responsibility for installing or failing to Install a thermal expansion tank. SERVICE ADDRESS: 7/^�� LOT NO. BLOCK PUT NAME: I/ CITY/STATEiZIP G LEGAL DESCRIPTION..' OWNER'S NAME: OWNER'S ADDRESS: �i<�� CITY/STATE/ZIP: The premises are to be used as a f(` C i f !' INFORMATION LETTER-GAVE/SENT: CHARGES: �PAID (1) Service installation d connection charge S /?a ' G.y) AUG O 1 IM (2) General Facilities connection charge $ 0 177.7 (3) other $ MUKILTED WATER DISTRICT Total amount received with application $ IT IS UNDERSTOOD that this Application, although signed. shall not be binding upon the MUKILTEO WATER DISTRICT until approved b the DISTRICT. ZldlI, the undersigned, owner (or representative) of the property described above, do hereby make application for inatdtetion c a -inch diameter water supply service connection including appurtenances, and all neces ry labor at my expenses. Daled this I day of_4 ' a APPLICANT'S SIGNATURE: ' I A I I's Name (please print) '/7 O pp ian •, f _ Applicant's Address and Phone Number: L / �� 3� ./gam Q�lt•G �/ APPROVED: MUKILTDISTRICT Bl, Date: