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• . . L. . ' ' . ' .�, ' ' <br /> Muca.�o w��aarn�cr <br /> s�+oNow�s�cou�n►w�s�arw+ <br /> �uc�no�FOR w�� � <br /> Application No. 53 ��v No, I " _��l <br /> Meter Size 3�y �� Number of Unitc � 1l000unl No. ���7�0�� <br /> I hereby apply tor water senice and apree to be povemed in aocor0ancs wNh the►esoMAbnt, niks�nd reputMbru ol Ihe <br /> MUKILTEO WATER DISTRICT perlainkq to waler �enioe, now or heroatter in effeCt. The underaipned as owner �r <br /> represemative o1 the herein•descrbed premises hereDy apreet�f lolbws: <br /> (t) Thn Ihe oost o1�ny eiMn�ion d fw wate��arvioe,rwiw�l.rep4a�nisnt a rprr b rwch�nd�erva Ihe propsrry Enaib�d�MA x Ea�w <br /> by my�eM«�scpne�c awner(�) of Ihe pr�mi�at. � <br /> (2) Thsl aN pips�,w�tw rt�wrinp A�Noes�nA atfxr oairweYrW�qNpensnt WMn�m kom M nwnr aM1.�her C�sir incupNon.ba rM 6eaar� � <br /> Ihe property of IM MUKILIEO WATER DISTRICT,wbjeA b�A Ih reqA�lion�pwt�4�kq b w�ter wrvioe. � <br /> (3) 7Tn dhr insnllsEm.H mslw M melar box and�pputenon ws buMA a 4mq�A.1Me ow�wr.wA b�Mtl teepoMble�ntl tMrpeE tor s�ms. y� <br /> (1) Tut k�MUKILTEO WATER DISTAICT,in olFwrs�n0 p�nk,thM M�►M ripht d irpr�r�nd prasa b yo upon M pwnMes�rW propwy � <br /> Ae�aiMd henr la tis purpo�s of impscion.ooreraYq a 6�oamecfrp/n»iMa�a br suoh oriw purpo»s n 1M�arvioe my nquhe. <br /> M i�eko unO�ttWOA httirp we Nn�IAtt airy d M Mhr mrM m�M wn d�vio�lry n�son d Mry wnerp�nry a improvwrwnts auMqrieW bC <br /> by Ihe DISTRICT.in�ny street w olhor be+on in M�ich My m�y hne bNn Nid.M DISTAICT wiA not W npik�0 a Mnw�MMw Aurkp W <br /> tlM propsn M wch impo�emenb b wry Con��nR 41qM Mqp�rmY Mw{M M dl.Or b�f�bM IOr wly AMlp�t 10�ilt taNute b Oo�0. J <br /> (5) That 1M DISIAICT�h�N Ifew M ripM b ehnq�M f�Y�M�ny lim!br NMoWlbfl,b NnpOrM�AMOonNnIN M Mrvi4 b OaMYmen,�nA C' <br /> w insuM IM msbr(t) to rpicbr IM w�ter consurnstl. TM D�STRICT�MN not bs fe1C IirbM lor A�m�pa br w�Mrx o1Asr ow�e rosuhirq 1rom <br /> AetscYrs Ph�nbi^0 a�pplianos�in�Wled by IM anwraexupwMon the pr�mMrt tuppG�lwMh wtiM.rW 1M IaalMtyenh ol we DISTRICT <br /> mry IrM Imp�dM�he pMm�bhq�nd�ppiMns�aMA not M pY�d r�Wab Im noerwy in qN d Mmq��s Nnrewia. Il llw N�pply d <br /> �wler sMA Mil abe inlert�p4Aby renon d�oaiMN.bnpr�wu�aMiwwuw M�wv�r�rr DISiRICT M�I notE�MN i�Lklarn�t <br /> nor shMl wch hihne a inlerniplbn br�ny renawbw Mnu M MIO b aen�MUM�b'Mch M aonlnct an M pwl of M OISTIqC1 a in�ny w� <br /> Mww M aonwmsr,wMlher MneN a arnw.kan pwb�mYy M abtpden of waA MwM's a owMr'�ooM�at. Wwr WI!�vM7 br <br /> �PP��1'on M pnmiws dewiWA Nroin. A nwv pylioron�hM M tiMd kwMA wMw M OninA la oC�w qwniws�Mw�A bo�Md <br /> on IarW Ae�arbsA I�erain. <br /> n�� 11M1 Mw d{TINCT r�e�4 N+wIMNsn N � N�wrn �u1MMy vMv�. A�N �akeewlMN� M�eerMn n w M <br /> . r�cen�n�nNlloe MW nwew�hAI nyenN�Mry Nr Mn�K I�NM»M ImYN�/rwwn npMNNy vdw�n M w�lw�plw�M <br /> M�Met H Ms�n MyA/r»wn. <br /> � nt TM OIfTIpCT �11Nt�a nh�ek v�WM tl M inMw M�wM wMM Mwnln�M M ONYkN InMM. TM q{T111CT n0�nr�nN <br /> M�4MM�n M�M�wn�l�t�bn 1�nk�e yrwhnl�sNw/n�wr�M�IN+�a�w�H�wMMrMr.A//Ma�b�M�M� <br /> '- MIa��Yen r M 1Mr noa��nMtbn MN��Nw�rs hi!tw��nNMlry Nr InNMlln�w MMn�M IMYII�IMrn�M w�rlM IMM. <br /> SF.RVICE ADDRESS: I��` / �I II�I �rl ,P I LOT NO. Q BLOCK <br /> y� ���tJ/�^ PWT NAME: R a <br /> CITYBTATFJ2IP: —{�E� �.I,f� (C�TI I 0 d U� LE6AL OESCRIPS'ION: <br /> OWNERS NAME: t � '—`n-�} rU c 1��o.-; - XT 1 �=�3 <br /> OWNERS ADDRES3: ���� 1• �j. �IX o�U. IC'.) - <br /> CITV/STATE2IP: r�C,Y�•.i.M4 �,'�.1"� -�S���- �lX.f 5 <br /> The premisee are W be u�ed ee <br /> _��1'7� � �" �"� � INFORAIATION LETTER-CiAVEBENT. � <br /> CHARGES: <br /> 1 ,1 <br /> (t)Service instelletion i mnneaion charpe � <br /> (2)Ganeral Fecilitias eonnection elwrps t / / �� 'U <br /> (3)O�her j <br /> Total amount received with�pplinYon f � 3��'UU <br /> IT IS UNDERSTOOD Mat Ihis Applicetion,atthough sipned,thaA nW be bindtq upon the MUKILTEO WATER DISTFICT unYl�ppro`ed by the DISTAICI. <br /> I,Me undersipned.owner(a repreeentaUve)ol the property dsteribsd�bovs.do Mreby trwlr�ppGabn lor�n6WI�Yon d• ��nch <br /> d�ame�er wa�e��uppI tervioe cormectbn,inclu¢rq appunenu�,rM rl neoesury labw�t m���p�nt�s. <br /> Dated thic ��L�l� day—ol7�� "' '1 � .1B `�(p <br /> APPLICANT'S SIGNATUREr -�1- I � ' VIQ S _ <br /> � ��.+-� ,�� S.T_�e��� PAID <br /> Applicanfc Name(de rint ' �� <br /> Appliranik Address end PMne Number: � �% �'�-'� wI:US �_�:�•��''��"�L�� � � � <br /> APPROVED: Y�T��IC..�1 �M "1£y.J4I-Z1X-� <br /> MUKILTE DISTRICT M��� wAj�R QISTRIL7 <br /> � �i �6 <br /> By: D�M: <br />