2020 HOLLOW DALE PL 2018-01-02 MF Import

Application No.� Meter Size — !i MUKILTEO WATER DISTRICT SNOHOWSH COUNTY WASHINGTON No. _ Number of Units 1;Z Account No. 111-� ;70l5 -Z) APPLICATION FOR WATER 15,5 I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations of the MIKILTEO 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 otl* 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 ani other connecting equipment upstream from the meter shag, after their installation, be and become the property of the MUKILTEO WATER DISTRICT, subject to aft its regulations pertaining to water service. (3) That after installation, if meter or meter box and appuNnoss are buried or damaged, the owner, will be held responsible and charged for same. (4) That the MUKILTEO WATER DISTRICT, its offoers and agents, shall have tie right of ingress and egress to go upon the premises and property described herein 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 koation in which they may have Wen laid, the DISTRICT will not be required to furnish water during the progress of such improvements to any consumer whose supply may thus be cut oe, or be fable for any damages for its failure to do so. (5) That the DISTRICT shag have the right to change the rates at any time by Resolution, to temporarly discontinue the service to consumers, and to install the meter (s) to register the water consumed. The DISTRICT shah riot be held fable for damage by water or other cause resulting from defective plumbing or appliances installed by the owner on the premises supplied with water, and the fad that agents of the DISTRICT may have inspected the plumbing and appliances shelf not be plead as a basis for recovery in case of damage as aforesaid. If the supply of water shag fail or be interrupted by reason of accident, low pressure or other cause whstwever, tie DISTRICT shall not be held liable for damages nor shall such failure or interruption for any reasonable time be hold to constitute a breach of contract on dos pan of tW DISTRICT or in any way relieve the consumer, whether tenant or owner, from performing the obligation of such tenanrs or owner's contract. Water shag be used by applicant only on the premises described herein. A new application shah be filed should water W desired for other premises sm"h located on land described herein. (6) That the DISTRICT reoommande Inoaftatlon of a pressure regulating valve. Applicant acknowledges Information as to the recommendelion and assumes full responsibility for Installing or faking to betel a pressure reguledng value on the 'wafor system to protect It from high pressure. TINT (T) The DISTRICT utilizes check valves at the meter to prevent water reltxnkg to the Districts mine. The DISTRICT recommends Installation ofathermal expansion lank lap rwantexcessive pressure build-up caused byfirewater heaNr. Applicamsadlnowledges Information astothe recommendation naannd/assume* full responsibility for Inststlkg or falling ng Install a thermal expensin tank. SERVICE ADDRESS: Gres'1111WLOT NO. 7 8UxK PUT NAME: CITYISTATE/ZIP: / 'A °17 OWNER'S NAME: ' r f % .—f� AIV A,, ' ^/T /r OWNERS ADDRESS: �,i•, CITY: STATE'ZIP: The premises are to bdl used as e LEGAL DESCRIPTION: G INFORMATION LETTER-GAVE/SENT: CHARGES: (1) Service insulation 6 connection drarge $ PAID (2) General Facilities connection charge $D 13 177V (3) Other $ r r Total amount received with application Svc MUIULTED WATER DISTRICT :T IS UNDERSTOOD that this Application, although signed, shag not be binding upon the MUKILTEO WATER DISTRICT unfit approved by the DISTRICT. i, the undersigned, owner (or representative) of the property descriWd,atavB, do hereby make application ter ineW4tbn of a Jrheh diameter water sujppy service connection, i rhg�ppurtenances, and all tarry labor at my expenses. Dated this �! . day of y ✓!� � .19 — . APPLICANTS SIGNATURE: Applicant's Name (please pnnt). f77 Applicant's Address and Phone Number: APPROVED: MUKILT TER DISTRICT 8)' Dale: ? y