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,^� � I� <br />Appiication No. �__ <br />Meter Size ._ <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER �� <br />No. <br />Number oi Units � Account No. <br />� <br />� <br />C.b�as�C���v U � <br />I hereby apply for water service and agree to be govemed in accordance with the resolutions, rules and regulations o( the � <br />MUKILTEO WATER DISTRI:T peAaining to water service, now or hereafter in ef(ect. The undersigned as cwner or � <br />representative of the herein-described premises hereby agrees as (ollows: � <br />(1) That tho cost of any estonsion of Iho wamr sarvice, renewal, raplacomont or;opair ro mach and serve the proporty doscrihod sheil be bome � <br />by mysotl or nssigns as ownor (s) of tho promises. <br />(2) That ail pipas, wa�er measuring dovices and other eonnoe6ng equipment �pstruam fro.n the memr shell, eker thoir installation, be and become i <br />the proporty of tho MUKILTEO WATER DISTRICT, subject to ell its mgulatlons Fertaininp ro wator serviee. � <br />(3) That aflor instn!la6on, it moter or moter box end appurtoncos are buried or dartiaged, tho owner, will ba held responsihle and eharged for same. L <br />(4) Thet tho MUKILTEO WATER DISTRICT, its oKcurs and agonts, shell hava thu right of ingross endegross to go upon tho premises and propery � <br />doscribod hnroin for tho purpose of inapecfion, connecting or diseonneeBng the service or for such other purposes as the service may mquire. <br />It is also undorstood during tho 6me thnt any of the werer mains may be out of service by reeson of any omergency or improvements authorized <br />hy the DISTRICT, in any stroet or other locauon in which they may have been laid, tha DISTRICT wiil not be roquired ro turnish water during <br />the progross of such improvemo�.its to any consumer whose cupply mey thus be cut oH, or be liable for any damagos for Its failure to do so. <br />(5) That tho DISTRICT shull have thn right to chenge fhe rares et eny time by Resolution, to temporarily diseon6nue rtie sorvice to consumers, and <br />. toinstallthamoter(s)toregistarthewalerconsumed.ThoDISTRICTshallnotbeheldliablofordamagQbywatororothorcausorosultingFrom <br />dotoctivc plumbing or applianws installod by tho owner oroccupan[ on tho promises suppliedwith watnr, and the fact Iha[agonts of tho D ISTRICT <br />may havn inspoctod the plumbing and appliancos shail not be p�ead as a basis for reeovery in wso af damage as aforosaid. II the supply of <br />wnter shall fail or be intorrupted hy runson ot accident, low pressure or other causo whatsoover, the DISTRICT shall not be hoid liable for damages <br />nor shall such failuro or iniertuptian lor any roasonable time bo hold to constituto a breach of contraet on the part ot the DISTRICT or in any way <br />reliove tho consumor, whothor tonant or ownar, from poriortning the ohligation ol sueh tenanCs or owner'a eontract. Water sha�l be used hy <br />� appliwnt oniy on the premisos described herein. A now applica6on shall be filod shouid water be dosired for othur promises although located <br />on land dos«ibad heroin. <br />iNT '(6) Thet the �ISTRICT racommends Inslellation of a pressure regu:ating valve. Applicent acknowladges Informetlon as to ihe <br />recommendetlan end easumes full responalblllty lor Inslalling or talling lo Install a pressure raguleting velue on the water system to <br />proiect It irom hlgh pressure. <br />i _(7� The DISTRICT utllizec eheck valves at Ihe meter to prevent water returning �o the Dlctrlets malns. The DISTpICT recommends <br />:�'� installallonofethermelexpendontenktoprevenlezcesslveprea�urobulld•upcausedbytheweterheater.Appilcenlareknowledges <br />Intormatlon as �a tba recommendaqone�Q assu/m�ea�1ull respondbii�y tor Inat Ilinp or lalllnp to In�tall a thermai ezpmaloe,tank. <br />� SERVICE ADDRESS: ��J I N1I�'�� �""IL r I LOTNO. � r` -� yy ( Blp�� <br />�y� PLATNAME: Lv LI.J��-GL1 J <br />CITY/STA7E/ZIP: �V�%r�- LEGAL DESCRIPTION: <br />OWNER'S NAME: ��` <br />OWNER'S ADDRESS: 2�, <br />CITY/STATElZIP: � <br />Tho promises aro to bo usod as n <br />�' S <br />INFORMATION LETTER-GAVe1SENT: <br />CHARGES: ���o(, <br />(1) Servico installation 8 connection charge 5 <br />(2) Ganoral Fncilitios connoction chargo <br />(3) Other <br />Total amount rocoived wiC� appliwGon <br />� a , <br />' �� <br />AUG 2 71998 <br />$ MUKILTEO WATER DISTRICT <br />s � ' <br />IT IS UND'cRSTOOD that this Appliwtion, althouph signod, shall not 6e hinding upon tho MUKILTEO WATER DiSTRICT un61 approved ¢y�t¢e DISTRICT. <br />I, �he undersignod, own r(or roprosontatiw f Iha propert doscrihad nbov�ereby make appliwtion lor insWlla6on ot a � -inch � <br />diamoter wator �pTy) �i�oico cannocuon, i G�ydn� aPpu ances, and all sary la6or at my exqtnses. � <br />Dated this li. / day of 1�•�C _,�g � <br />APPLICA�TS SIGNATURc: � / � <br />� s?� � ,�r -3 y7-sz7� <br />, Applicani's Name (pluase print): , � <br />` Applicant's Address and Phono Numbor: <br />APPROVED: �-- [/ '�+-��� «/ '' /G �" 7 <br />MUKILTE TER DISTRICT <br />RY: ��� Date: _ U _ <br />