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PLICATION fJO.�_.? <br />_ accounr No.L��il ��= 9ioL <br />MlJKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY, N'ASHINGTON <br />APPLICATION POR WATER <br />� � �' RK ORDER NO. ��� " `� y'�� <br />E — . ?F � � — <br />tdukilteo, Washinglon � ' � U , 19 � � <br />T:{E 6U?EAII2TENDcNT OF THE MUI;ILTEO WhTER DISTAICT; <br />' FereSy apply lo: ihe use ol N•ate: in accordance with the rulec and teaulations o1 <br />Mukilleo Wa1e: Districl. ' <br />lluring the time th21 any o! ihe walr. mainc nmy bc faken up by reason o! on}• �m- <br />+cment authorixc by the Di,t:ic� ir. or o1 any ctreet, road o: alley in which they may <br />e been laid. ihe DicL•ict will no: be required to lumi:h water during tne p:oaress ot <br />� improvemenic to ony consumer whose �upol� rt�oy ihvs be cui o1;, o: be Lvble for <br />domagc fo: ita tailu:e se to do. <br />Thc owncr shall bc liable !or an5' damagcs tu thc scn�cc conncction. <br />�rraTv uesce���rion: : a -�- / � /� .,�Sd' <br />/ .o / <br />u� Ll.Shmc.� /1C��itic �'r-�t�rtli-� ����G <br />�� <br />�FESS: <br />/G L` J/ J'7 r io �z, � c, � <br />� size of se:eice `� c inch <br />�.._ ST�.yco7��3c� <br />i��%• �� =hac been re:eived witn thic applic�tion. <br />pten:ises are to bc used as a T ��� �� 1-� .v� .'� _ <br />ow�ne: ot the premises ic J��? 4� O L l.��c U G'IS <br />agent i�_� <br />r ,L y �- _--y /� / - <br />D'ne�1Ji � t re.^oytm� ��'n`t�allat o nl a"pre;����uulalin�— <br />i+pplicent acknp«•ledges in(o:mation e- lo (hc reaommendntion and . <br />res to instal! e•sure roaul In valvc � �� <br />i <br />�i�tned I ' =.._�� �<�� - _— <br />ines to insWll a presnure rcgulating vah•e <br />3igned _ _ <br />is undcrslonJ thal all conncctions, inciuding mctcr and mctcr buti shalt rcmain lhc property oC <br />Itco \1'a�cr District. <br />PAID <br />P 10 1987 <br />ic0 WATEP, DISi <br />$14net] �.� �/ `_ (.( �i�. QH•:1C: <br />/ �J <br />Adbress �C C// �%!�Cn7L .r h�� q <br />By /_ �� : i � r %7 , Lc. : � % d .1(,e� , h9en; <br />Addtess_s�' S�_�' -� d' Y n_ � m. <br />35��'1�'%l�r�� L,��C. <br />rOR OFrICE USE ONl <br />DATE COMPLETED <br />POST TO ACCT !a0. <br />�7G. � d'� <br />AL MATERIALS COST I� <br />�OR METER CHANGE ONLY <br />4DING <br />3. NO. <br />IALING <br />R. NO. __ — <br />7 REPAIRED G <br />'eQU1PMENT RENTAL <br />NAME � COST <br />10. � <br />IUCK <br />�E <br />:SSOR <br />_ TOTAL EOUIP. <br />LABOR <br />;_1�111� tzt_raUa� <br />.,.,� = nl� /.'. I, <br />UO <br />��. �' n <br />� <br />COST <br />y 3�' <br />TOTAL LABOR COST � IG,��. 7� <br />TOTALCHARGES "ry`�'�� - <br />__ ADD �y 9oOVERHEAD 33�`_2_ <br />TOTAL OVERALL _ � 7 L' �� - <br />CUSTOMER CREDIT <br />