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C� �.:: - <br />APPLI�B.TION NO. ___!,_ � _-- ACCOUI.T NO. � '�`" J- <br />� <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY. WASHINGTON ��� <br />APPLICAYION FOR WATER� <br />ldukiltoo, Y!¢saington �� "Z'S . 19-'�� <br />TO THE SUPEAl1�TEtSDENT OF THE �771:iLTEO \':hTER DISTRICT� <br />1 heteby apply lor fhe use al wa�e,- in a-cordance wilh fhe rules and regulations o1 <br />the Mukilteo Water Districl. <br />During ihe timc Ihat any o! lhe watr. mains mcy b� laten uF by reason o1 any im- <br />provement autho:ized by the DisL•ict ir or o! any stree;, road o: alley ir. uhich they map <br />hove been laid, the Distric! will not be required Ic iurnich wclet du:inG the prov:esc ol <br />such improvemer.L• �o any conr,umer whose sunplg may thus be cul oll, o: he liable lor <br />any oamagc lo: its failure so to do. <br />The owner shall bc liable fot am• dama��c to Oic scrvitt connection. <br />PROPBItTYDESCRIPTION: �-1%% � h� �-- <br />r <br />RK ORDER NO. ��'' � �i/' � <br />4' � —.'.� <br />'E , �_ � <br />'OR METER CHANGE ONLY <br />1DING <br />?. N0. <br />4DING <br />R. N0. <br />11Quc(:;.� �.i.�fh('�• IJiY .� <br />i REPAIRcD ❑ <br />E'�R�.,,— ti �a� <br />tiunAEss: /�CiO.�.� ��u;,�T�j�.';a Fa. <br />Stale size ol service �� :nch <br />y!"Z�G. Unn�; beer. receivva �: ith this npplicafion I. <br />The premises are to bc used es a_'� t^ �T-' �� �� �1J� A�ic1�'�'�-�-4—' <br />liicowne:o!thepremisesic �'—` �Q��R+�C �1`��!l)]'�—'"���'ttLL <br />Thc ngent is <br />The District :ecommends in;tallaL�r. oi a ore,^.um regulaling valve. <br />Applimat a:}:nowdedges inlo:mation cs to the recomnendation and ... <br />Aarces to inctall c pmssurm maulatina valvc <br />De�fines la instal; a pres.ure <br />s�an�d r ,,_,�� <br />ealve <br />r ;i n <br />It is undcrslood Oiat all conncetions, �qcluding metc� and mc�cr buc shall rcmain �hc p�opert�� oC <br />Mukiltco 11'atcr Distnct. <br />�f� � � /?�� �� � / � <br />r�6 i uigned �_�_' :� �.� �� ,• -•�� _, Ownc: <br />IUI�ILI�O l'dF,TEF UISi <br />B <br />:_ , <br />„aa«_:.— �� � � b.l� ��'3�' ,� <br />p,. __ Sc�_ �TI [ C! 5� 15"' ,:,���c <br />� �, _ � <br />e aa.,.,.. 7�- � b l, _ <br />TOTAL MATERIALS COST I-�'� � <br />FOR OFFICE USE ONLY: <br />DATE COIdPLETED _� - 1 �= - ��.'� <br />POST TO ACCT NO. .� 1.�.'-t-?u `' -- --��L-l-.+�---- <br />1�,4 C,'�, �'i <br />1-�-� •�v.t� � <br />iQUIPMENT RENTAL <br />NPME � COST <br />` <br />�. � <br />1CK <br />SOR <br />LABOR <br />j�.' l� /'L ! - � <br />�l s <br />! /rI/Y' <br />�S� <br />TOTAL EQUIP. I ��SC' <br />COST <br />�� <br />TOTAL LABOR COST I �•.�-. u <br />TOTAL C�/HARGES . _ � /7' � 'S _ <br />ADD � `r °- O\'=RHEAO � �� � �� �= <br />,:'n � `P, <br />TOTAL OVERAL�. ' � <br />CUSTOMER CRED�T <br />