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� • <br /> � 1 <br /> 1 <br /> • i <br /> PRv ,paR�EM�NT <br /> Tha undersiQned hereby requests the City of Everett to waive <br /> Ithe PAV charga on his/her water service at <br /> ' � �Q�����yf,t����s�f�!_. Tha underaigned <br /> ! represanta that the sarvice at said location presently has a PRV <br /> Iin good working order and that, in consideration of waiver of <br /> said charQe, for the period that undersiQned is a Water service <br /> cuatomer et the above location, the undersianed aarees: <br /> � 1 . To maintain said PRV in good workinQ order; and <br /> 2. To releasa the City c.' Everett from any and all <br /> liability arising from increased operating pressures on <br /> the �5 transmission line to which the above water <br /> • service is connected; and <br /> � 3. To indemnify and hold harmless the City of Everett from <br /> � any and all claims related to the failure of the PRV <br /> ! installed at the above location. This indemnity is on <br /> Ibehalf of the undersigned, and the undersiened agrees <br /> � to notify the city of Everett of any chanee of <br /> I ownership of the Water aervice connection at the above <br /> location. <br /> 1 DATED this � day oP � 1M6� � 1987. <br /> � <br /> � <br /> , <br /> STATfi OF WASHIN(3TON) . <br /> ,. � � ss: <br /> COUNTY OF �1�:�Li) <br /> I certiPy that I know or have satisfactory evidence <br /> i that �¢���Msl L�t�o�t`L�-�i' signed this <br /> I instrument and acknoWledged it to be (his, her, their) free <br /> Iand voluntary act for the uses and purposes mention in the <br /> I <br /> j instrument. <br /> I <br /> iDated: yP7 ------- <br /> ; (Seal or Stemp( Signature of <br /> i Notary Public: _ _ <br /> � <br /> Title� � <br /> IMy ccmmission expires: ��a�f _ <br /> i <br />