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, - <br /> .., . �.. <br /> �__..z► '�- <br /> ' MUKILTEO WATER DISTRICT ^[ <br /> SNOHOMISH COUNTY WASHINGTON r <br /> V <br /> APPLICATION F/OR WATER '— C <br /> ^`�Application No. � /` � ���9��j �j <br /> / � No. <br /> IdeterSize � NumberofUnits AccountNo. D�CJ�(�7b�YS�� � <br /> I hereby apply for water sen�ice and agree to be governed in accordance wifh the resotutions, rules and regulations of the <br /> � <br /> 1�1UKILTEO WATER DISTRICT pertaining to water servic:e, now or hereafter in effect. The undersigned as owner or °� <br /> representative of the herein-described premises hereby agrees as fotlows: �C <br /> (7) That the co;t of any eztension of the water cervice,renewal, replacement or repair to mach and serve the property described shall be bome � <br /> by my:elf or assions as owner(s) of ihe premises. <br /> (2) That all pipes,water measuring dn��s and otherconnecting equipment upshoam irom the meter shall,aftertheir installation,be and become <br /> the property ol Ihe MUKILTEO bVATER DISTRICT, subject to all its mQulations pertaining to water srrvice. <br /> (3) 7hat altcr inshlla(ion,if ineter or meter boz and appurtences are buried or damaged,ihe owner,will be held mcponsible and charged lur same. <br /> (4) That the NUY,I LTEO VJATER D ISTRIGT,its offirnrs and agents,shail have thc riaht ol ingress and epmss to go uFon the nremises and property <br /> described herein for the purpose ol inspection,connecting or distonnecting the service or br such other purposes as the service may requim. <br /> It is also understood during[he time that any ol ihe water mains may be out ol service by rea6on of any emergency or improvemenis authorized <br /> by the DISTHICT,in any street or olher location in which they may have been laid,the DISTRICT will�not be mquired�o turnish water during <br /> Ihe progress of such improvements to any consumer whose supply may ihus be cut oH,or be liable for any damages�or its failure to do so. <br /> (5) That tho DISTRICT shali havo the nght ro chengo the rates at any time by Resolmion,to tomporarily discontinue the service to consumers,and <br /> toinstallthemeler(s) toregislcrthewaterconsumed. ThoDIS7RICTshallnotbebeldliabletordamagebyw•aterorotherwuseresuitingfrom <br /> dofective plumbing or appliances in stalled by the owner or ocwpant on the premises supplied with water,and the lacl that agents of the DISTRICT <br /> may have inspocteA ihe plumbing and appliances shall not bs plead as a basis for recovery in case of damage as aloresaid. If the supply of <br /> wr�,(�.ahali fail or be interrupted by reason of accident,low pressure or othor cause whatscever,iho DI�TRICT shall not 6e held liable fcr tla mages <br /> ❑br shall such tailure or interruption lor any roasonable time be heid to constitute a 6roa:h ol eonirect on ihe part of the DISTqICT or in any way <br /> � rolieve the consumor,whether tonant or ownor,irom pedorming ihe o6ligation ot such tenanPs or owner s contrect. Water shall be used by <br /> / applican�only on the premises dasaibed herein. A new application shall be filed should water be dosirod lor other promices allhough located <br /> on land described hereia � .. <br /> vir. �� ) Thet Ihe DISTRICT recommends Inslallalion ol a pressure reguletlng valve. Applleant acknowledges information as to the <br /> r� J recommendetinii and assumes lull responsibllity lor In�talling or falling lo Instell e pressure regulating value on ihe water ayalem lo <br /> �/ � prolect It from high prr.ssurc. � - <br /> _(7) The DISTRiCT utilizes check valves at the me�er to prevent water relurning to Ihe DIslrlcis mains. The DISTRICT recommends <br /> ,� instatlallonolathermale�pansiontankloprevente�cessive'pteesurebulid•upcausedbythewalerheeter. Applicantsecknowledges <br /> ��.� <br /> Inlorma{ion es lo ihe recommendetion enA ecsumea�uii responclblity for Inslalling or felling lo Instail a Ihermal erpansion tank. <br /> SERVIGE A�DRESS: �U /;�lq,.��,e�.E./���T NO. BLOCK � <br /> PLAT NAME: � ��'�.�� � <br /> GITY/STATE/ZIP: i "JZ� ����LEGAL DESCRIPTION: Ol///�� � <br /> OWWER'S NAME�� ..��./�/„/ �/��i�t-��, �� i � <br /> OWNER'S ADDRESS: _. �ri+'.7G/ � �Y'G�.J',.L` >t'r <br /> CITY;STATE2IP: .�,�,i �/�.���� <br /> The premises�to bc used as a � <br /> -=� ��'�� . INFORMATION LETTEP�GAVE/SENT: , ` <br /> � CHARGES: l� ' / ` "-� �� <br /> !1)Ser.•ice installauon 8 eonnection charge $ �/ �• �V <br /> (2)General Facilifes connection chargo S ��6 �. � JAN 1 2 1995 <br /> �a�om�r s — MUKILTEO WATER DIS?iE1CY <br /> Total amount received with application 5 � • � <br /> IT I:19;p-q�TOOD Ihat Ihis Applicatior.,althouqh signed,shali not bo binding upon the MUKILTEO WATER DISTRICTuntil approv d by the DISTRICT. <br /> I, Ine undersigned, owner(or iepresen itive)ot Ihe propetly described atwve,do hereby make application for inetallation ol a�� �/ <br /> ! -inch <br /> diameier wa�or pty service eonnec io Mcludmg appurtenanws,and all ne eSSS��6 ary labor at my ozponsos. <br /> Dated this �_ day f �� .�ti,i �g � <br /> APPLICAIJT'S SIGNATURE' d. 1��{�"/ _ _ � 9 //-/q� <br /> ApplioanPs Name (please prinq: L'�l��'`���� ��4-���Ll o✓ y � �� �y�Gfj'(� <br /> " � Applioani's Addicss and Phonc Number� ? l�'���� S�� %S �`! /�.;C � <br /> APPROVED• ��l %�- � '�� G'�-f <br /> NIUKILT T R DISTRICT <br /> i �i���...� <br /> �'>' - -- � oate: / /3��_ <br />