1903 HOLLOW DALE PL 2018-01-02 MF Import

MUKILTEO WATER DISTRICT SNOHOMISH COUNTY WASHINGTON / 2� APPLICATION FOR WATER �} /y Application No. r W No, — I ?Uog5 l� �S,Gb Meter Size Number of Units � 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, ronewa!, replacement o• repair to reach and serve the property described shall be bome by mycolf or assigns as owner (s) of the premises. (2) Tnat all pipes, water measuring devices and other connecting equipment upstream from the motor 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 motor or motor box and appurtences are buried or damaged, the owner, will be hold responsible and charged for same. (4) That the MUKILTEO WATER DISTRICT, its officers and agents, shall have the right of ingress and egress to go upon the promises and property described heroin for the purpose of inspection, connecting or disconnecting 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 to tumish water during the progross of such improvements to any consumer whose supply may thus be cut off, or be liable for any damages for its failure to do so. (5) That the DISTRICT shall have the right to change the rates at any time by Resolution, to temporarily discontinue the service to consumers, and to install the meter(s) to register the water consumed. The DISTRICT shall not be held liable for damage by water or other cause resulting from defective plumbing or appliances installed b, the owner or occupant on the premises supplied with water, and the fact that agents of the DISTRICT may have inspected the plumbing and appliances shall not be plead as a basis for recovery in case of damage as aforesaid. If the supply of water shall fail or be intorrupted by reason of accident, low pressure mother causo whatscover, the DISTRICT shall not be held liable for damages nor shall such failure or interruption forany reasonable time be hold to constitute a breach of contract on the part of the DISTRICT or in any way relieve the consumer, whether tenant or owner, from performing the obligation of such tonanrs or owner's contract. Water shall be used by applicant only on the promises described herein. A now application shall be filed should water be dosired for other premises although located on land described herein. ,nr (6) That the DISTRICT recommends Installation of a pressure regulating valve. Applicant acknowledges Information as to the recommendation and assumes full responsibility for Installing or falling to Install a pressure regulating value on the water system to protect It from high pressure. y (7) The DISTRICT utilizes check valves at the meter to prevent water returning to the Districts mains. The DISTRICT recommends installation of a thermal expansion tank to prevent excessive pressure build-up caused by the water heater. Applicants acknowledges Information as to the reco dati�o}n ead a sum lea) all responslbllty for Inslallin or falling to Install a thermal expansion tank. SERVICE ADDRESS: NO r v ��O"— � � l� � LOT NO. I BLOCK 4 t 11, A 74 1 A _ IQP ^ I PLAT NAME: 1' • ( 9 CITY/STATE/ZIP: OWNER'S NAME: C1 OWNER'S ADDRESS: P- 0 . a_)V 17 CITY/STATE/ZIP: S1W9f,—A.4,(..t LEGAL DESCRIPTION: The promises are to bn used as a - (Jt-VW-,k 1. INFORMATION LETTER-GAVE/SENT: DD CHARGES: ��'� F AW (1) Service installation & connection charge $ % OCT 0 9 go(2) General Facilities connection charge $ (3) Other $ UKILTEO WATER DISTRICT Total amount received with application S 5 ' :t IT IS UNDERSTOOD that this Application, although signed, shall not be binding upon the MUKILTEO WATER DISTRICT unfit approved b the DISTRfCT. I, the undorsigno�p or (or roprosental vo) dl th property described abovo�fo ereby make application for installation of a - -inch diameter wator Zy servico connect n, enances, and ell sary labor at my expenses. Dated this day of ,19 ��1 (((ll(111111 �+� APPLICANTS SIGNATURE: _ / Applicant's Name (please print): �Applicant's Address and Phone APPROVED• MUKILT TER DISTRICT By: Date: 'i1 X6 U C C V L L