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• . • I v� � e , . . .� ... _� _� .� � . !� �.0 ... �.t>�� .�. <br /> I � <br /> � MUKILTEO WATER DISTRICT <br /> SNOHOMISH COUNTY WASHINGTON <br /> �� O <br /> � . APPUCATION FOR WATER � <br /> �/ �(Jf�� <br /> IAPPlication No. � �� No. � <br /> I <br /> MeterSize J NumberofUnits ( AccourrtNo. U�—��� y7� J <br /> I hereby apply for water service and agree to be govemed in accordance with the resoiutions, rules and regulations oi the � <br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in efiecl. The undersigned as owner or J <br /> represerrtative of the herein-described premises hereby agrees as follows: Q <br /> (1) That the cost ol any oxtension ot tho wator sorvice,ronewal,replacement or repair a reach and a¢rve the proporty described shall be bome O <br /> by myseit oi assigns as ownor(s) of the promisea. � <br /> (2) That all pipea,water measuring devioes and otber connectinp equipmenl upstream irom Me meter shal�,eftar their installation,be and beeome <br /> . thc p�operty of thc MUKILTcO WATER DISTRICT, subject to all its repulations peRaininp to water service. <br /> �� (3) That aNer installation,if ineter or meter box and appunences are 6uried or damaped,tlre owner,will be beld responcible end eherged for same. <br /> (4) Thet the MUKILTEO WATER DISTRICT,i�s oHioarc end apentc,ehell ha�e the ripht of inprese endeprees W po upon the premises and properry � <br /> j% dosaibod herein tor the purpose ot inepoction,connectinp or dieeonneetlnp tl�e tervioe or tor such other purposes aa the service may require. � <br /> �- It ic also undorstood during the time that any of Ihe werer meinc may be out of servios by reason ol any emerpency or improvemente authorized `1 <br /> by the DISTRICT,in any streot or other location in which they mey M1ava been laid,U�e pISTRICT will not be required tn fumich water durinp <br /> the propmss of such improvements Po eny wnsumer whose cupply may C�uc be cut off,or b9 iiable lor any damages tor its failure ro do so. <br /> (5) That the DISTRICT sball have ffie right ro chanpe ttie ratec et any tirne by Recolution,to tempaarily diswn6wa the service to conaumers,and � <br /> to install the meter(s) to repister the wat�r consumed. The DISTRICT chetl not be held iiable lordamape by water or othar puse resuitinp hom <br /> �� defectiveplumbingorappliancosinstalledbytheavnerorocapantonthapremiseswppliodwiffiwaror,endlhefactthetegentsofthoDlSiRfCT�.. <br /> may have inspected Ihe plumbing end appliancas ehell not be plead ee e basis tor recovery in case ot damage as eforosaid. If tl�e eupply ot <br /> watQr shall fail or be intortupted by reason ol acddent,low pressure or other cause whatsoover,Ihe DISTRICT shell not be held li�ble for damagEs <br /> nor shall such failure or intertuption forany roasonable time be h:�d to oonefituto a breach ol mMreet on tlie pert o�tlie DISTRICT or in any way <br /> relieve the coneumor,whothor tonant or owner,Irom peAortning the obligefion ol euch tananY�or owneYs contreet. Water shall be ueed by <br /> applicant only on Cre promisas desaibed herein. A naw epplicatlon shall be filod snould watar be desired fw ottier premises although located <br /> wr ��/ on land decaibed herein. <br /> `(Q)-Thet tMe DISTRICT rorommmd� Inatalletion of � pro��un roguletinp velvs. Applieant adcnowledpes Informatlon a� to the <br /> recommendellon and asoumea full responsiblllty tor InatallinA or t�llfnp to Imtatl�prnsura repul�ting vrlue on the w�ter�yslem to <br /> _�protecl l�from high pressure <br /> �? _T" 'The DISTRICT utilizes ehack velves at the meter to prevent water roturninp to tha Dl�trlets mNns. The DISTHICT recommends <br /> I U.cdlatlonot�tM1ermalezpen�iontanktopreventezcs�alvepraawrebuild-upc�u��dbytbew�lerheeter. Appllcanb�dtnowledge� <br /> ��` . Intormetlon u�to th,e rocomm�dntion�nd wumn tull respomibilly for In�tdlinp or t�Ilinp lo I�nsuyll[tl�ermil pzp�nsion lank. <br /> ( ` ^ � ' 11l � '�r����(�orNo G� C?IiLf.)�C�) �-��t r(s <br /> SERVICEADDRESS: � t �Y �., IL� �jr 1T` _�8� O K�• 'j <br /> � r -�pLAT NAME: Yi.�.I�� � I� f� �C � '' Ch <br /> � . � " y <br /> CIlY/STATE/ZIP� `�� � -'/L'� !l � LEGAL DESCRIPTION: <br /> OWNER'S NAME: I I�Z/- :i�� /{�/!PS ]S�/C_ <br /> OWNER'S ADDRESS: f'��' ��Y ���e2 <br /> CITY/STATE2IP: LY�"�' W'n s'6'o?� <br /> The premises ara to bo used as a -�"'��} l�j�-�. �-�t.� �ll �!-, <br /> `' 'J INFORMATION LETTER-GAVE/SENT: �' �� �T Y <br /> CHARGES: n� / �j� <br /> (1)Servico insWtlation 8 conneaion charge $ �� -}� � ��� ^-*'�'� <br /> I J` I Gu <br /> (2)Genoral Fadlities conraction chargo s FEB � � tg9g <br /> . (3)Olher $ • <br /> Towi amount received with application S ��'�+ �� ` MUKILTEO WATE� DISTRICI <br /> IT IS UNDERSTOOD that this Appiica�ion,ai�hough signed,shail not be bin�ing upon tha MUKILTEO WATER DISTRICT unGl approve�db/thf�DISTRICT. <br /> I,�he undersignod,ow or(or repmsenutiw)of the proporry descnbed above,do hereby make appiication for installation ot a �y. -inch <br /> diameter walor 5uf�pl�servico wnnec6on,'�tlu1y,i y�pp�n n n s,and all �a ry labor et my ezpenses. <br /> Datedihis � I dayof _ �-t.�1 � lA (.-� ,�g �G <br /> APPLICANTS SIGNATURE: � , <br /> � APPIiwnYs Namo(ploase pnnQ: ��"�!/ t'�� "r��y <br /> `"� ApplicanPs Address and Phono Numboc_''"2'"' �n��� L+-.✓.✓iey,; (�,4 `�i C}L `'.�� � 7�3 -r Se�� <br /> APPROVED: <br /> MUKILTE ATER DISTRICT <br /> By: �6� Date: � <br />