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� `/ � <br />F' . i:., <br />Y �". �� �� MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />• ' C `� � r � �� ✓. C. �"� � <br />APPLICATION FOR WATER <br />appiication No. � <br />� <br />-�. -a...�T.Tr +r�•� v 'F <br />No. <br />O <br />� <br />� <br />Meter Size j/q�'� ��� Number oi Units _ Account No. —�� �� <br />I hereby apply for water service and agree to be governed in accorc :nce with the re�Dlutions, tU e� ndYe��atl6ns of the <br />MUKILTEO WATER DISTRICT pertaining to �vater servica, now or hereafter in efiect. The undersi;ned as owner or <br />representative of the herein•described premises hereby agrees as follows: <br />(1) That the cost ol any oxtension of the water service, renewal, replaxment or repair ro reach and serve the properry described shell be bome <br />by mysell or assigns us owner (s) of thc premises. � <br />� (2) That all pipos, water measuring dovices and other connac6ng equipment upstreem from thematar shall, altor their instailation, be and 6ecoma <br />thc proporry of the MUKILTEO WATcR D�STRICT, ^uhject to all its regulations partaining to walor service. <br />(3) That after installation, il moter or metar box and appurtences aro buned or damaged, the ownor, will be held responsiblo and chargad for same. <br />(4) That She MUKILTEO WATER DISTRICT, i:s olficors and agonts, shall have the ripht of inpress and egross to go upon the premises and properry <br />desaibod hnrein for Gio purpose of inspection, connecting or diuqnnecting the sorvioe or for such other purposes as the service may require. <br />� h is also understood during the time that any ot ihe water m•'is may be out ol service by reason of any emergency or impmvemonts authorized <br />6y the DISTRICT, in any sVeet or o;hr,r location in which @�ny may hava been laid, tho DISTRICT will not 6e required to furnish water during <br />the progross of such improvements to any consum�r whose supply may thua be cut off, or be liable for any damages for its failure to do so. <br />(5) That tLo DISTRICT shall have the right to chnnge the rates at any time by Rosolution, to temporarily oisconGnue 8ie service to consumers, and <br />toinstallthommer(s) toregistorthewaterconsumed. TheDISTRIC?shallnocbeheldiiablefordamago6ywarorormhercauseresWtingfrom <br />_ dolecliveplumbingorappliancosinstalledbylhoowneroroccupantonthepremisessuppliedwithwater,andthofadthatagentsoftheDIS7RICT <br />— --may have inspocted tho plum6ing and appliancos shall not be pload as a hasis for recovory in case of damage es afomsaid. If the supply of <br />woter shnll fail or be interrupted by roason al accidenl, low pressure or other eauso whatsoovor, tho DISTRICT shall not 6e held Iia61e for damages <br />nor shall such failure or interruption fornny �oasonablo time bo held to mnstiNte a breach ot conlract on the part of tho DISTRICT or in any way <br />� roliove the mnsumor, whother tenant or ownor, from pedortning Ihe obligation ol such tonanPs or owner's contract. Water shall be used 6y <br />- . applicant only on the pramisos described horein. A new eppiiwtion shall bo fi'^d should water be dosired lo• othor promises ahhough �ocatad <br />on land desaibed herein. � <br />iN; �/i (6) The� the DISTRICT recommends Installatlon ot a pressure regulatlnQ velve. Applfcent ackno�+ledge¢ In(ormation aa to ihe <br />7Y7 recommendetlan and assumea full responsiblilty tor Instelling or falling to InsOill e pressura regula��,�g value on the wa�er syslem to <br />- pro�ecl It from hfgh pressure. <br />inT-� i n (7) The DISTRICT ulilizes eheck valves el the mater to prevent wster retuming io the Oiatdcts meins. The DISTRICT ecommends <br />�-h` � installetionolathermelexpansiontanktopre�entexcessivepresaurebuild-upcausedbythewaterheeter.Applicentsacknowledges <br />� <br />� Informoqon es 10 Iho recommendatfon and easumes full responalbllty for (nsUlling or lalling to Install a thetmal expanslon tenk. <br />SERVICE ADDRESS: �E� �� /7 ��. 1 � � / LOT NQ � � :a <br />, r-7"—"-�„T-t5i,:�-=-�— -- _, BLOCK <br />CITY/STATFJZIP: _ <br />OWNE!i'S NAME: -_ <br />OWNER'S ADDRESS: <br />CITY/STATE/ZIP: - �;�.-� <br />�- _. . <br />Tho promises aro lo bo used as a '� %� ' <br />+ �/ .� C �. �..11L/- !_ <br />� T <br />✓ <br />PLAT NAME: �� .� ���� /- h p� <br />" J�. � '�+ \ � <br />LEGAL DESCRIPTION: _ <br />INFORMATICV LETTER�GAVE/SENT: �-�/.e <br />—�` 7"C_-- <br />CHARGES: <br />(7J Servico instailation & connection charge <br />(2) Genoral Facilities eonnection chargo <br />(3) O(hor <br />`�!� � � i �: �-- <br />���E�_., <br />ToWI amount rocoivod with application S.—:' '� •�� l � E <br />. _,� L <br />IT IS UNDERSTOOD that this Application, alihough signed, shatl not 6o binding upon the MUhILTEO WP.TER DISTRICT unGl approved by the GISTRICT. <br />I, the undersignod, owner (or represont�tive) of tho property do:cribed rtbove, do herti5y maFs opplica5on for installaGon ol a <br />diamomr watur supply servico connection, includirp appunanances, and ell nocossary labo� at my oxpanses. " <br />Datr.d this _�_ day ol ` J ,19 _� �, <br />. � � � <br />APPLICANTS SIGNATURe:��"�� _ ��-� / <br />Applicani's Namo (ploase print); � � � Y � �' ))� <br />�`..�pplicanPs Address and Phono Number. �_ � �� <br />� APPROVED: �- <br />A7UKILT WATER DISTRICT <br />. <br />sy: <br />� � <br />f� ,� i/Gc� <br />a : _ <br />� � i -inch <br />,C_AiL <br />OCT 2 61989 <br />7L <br />C <br />MUKILTEO WATER DISTZICi <br />