|
�lie.-`,r 1' _.�: . � . . , ^
<br />.4';l - 3 �� :,�-' •� � ^ � � . • l/
<br />. ? `; � MUKILTEO WATER DISTRICT �� �
<br />�'' ' SNOHOMISH COUNTY WASHINGTON �� � � 1
<br />� . v � - : , %S `i
<br />r. APPLICATION FOR WAT�� u DO
<br />�pplication No. �O
<br />No. •
<br />MeterSize —/ SV�, y, Numberol Units � C
<br />�— Account No. �a70 —/�' D�� d�,
<br />I hereby apply tor waler service and agree to be governed in accordance with the resolutions, rules and regulations oi the �
<br />MUKILTEO WATER DISTRICT pertaining to water service, now or hereatter in effect. The undersigned as own�;r or �
<br />representative of the herein•described premises hereby agrees as follows: �
<br />;1) That the cost of any axronsien of tho wamr sorvico, renawal, replacement or repair to reach and serve the proporry dascribed shell bn bome �
<br />by mysolf or assigns as ownor (s) ol the premisos.
<br />(2) Th�tallpipos,watc-moasuringdavicosandotherconnectingoquipmentupstreamfromthemetarshall,ahortheirinsWlla6on,beandbernme
<br />1ho proporry ol tho MUKILTEO WqTER DISTRICT, su6joct to all its regulnfions perteining to water sarvico. �
<br />(3) Thal aher installation, if moter ormetor box end eppurtences are buried or damaged, the owner, will be held responsi6le and eharged for same. �
<br />_ (4) That thn MUKILTEO WATER DISTRICT, its oflicars and egonts, ahall hav� the right of ingress and enrnss to go upon tha pramises and property
<br />describod horoin for tho purpose of inspoclion, connecting or dseonnecting tho sorviw or lor sucF, othor purposos as the sorvico may require.
<br />It is also undcrstood during the timo that any of �he water meins may be out of servica by reason ot any omergonq or improvements outhorized
<br />6y iha DISTRICT, in any strool or othor lowtion in which they may have beon laid, tho DISTRiCT will not be requirod ro furnish water during
<br />the pragross of such improromants to ony consumer whose supply may thus be eut oH, or be liablo for uny damagns for its failure to do so.
<br />(5) That the DISTFICT shall have the right to change tho rates at any time by Resoiution, to temporarily discontinue tho sorvieo to consumcrs, and
<br />to install Iho moter (s) to rogistar tho warorconsumed. The DISTRICT shall notbo held liable fordanage by walcrorother wuse rosulting hom
<br />dolecGve plum6ing or appliances installed by the ownororoecupant on the premisaa supplied wiffi wator, and tho !act that agents of tho DISTRICT
<br />may hayc inspqctod�ho plum4� d applianc�s shall not be load as a basis lor rvcovery in case of dumage aa atoresaid. If tho supply of
<br />wat r�5 Iljailoft��btoirupje�hy��e�Sonotaccident,lowprassureorotherwusowhatsoawr,theDISTRICTshollnotbeheldliabiefordamagos, •�
<br />nor shall si oh lailure or iNerruption for any roasonable timo ba held to wnstitute a breach of contract an the part of tho DISTRICT or in uny�way
<br />rolievo tho bnsumor, whathor tcr.W,t or ownor, hom poMorming the ohligaGon ot such tananCs or ownor's contrua. Wator sha�l he used by .,�
<br />applicanl only on tho promisos describod haroin, A now applica6on shall be lilod shouid wator be dosired icr olher pramises elthough located '
<br />on land dos_ribal hemin.
<br />Kint y��(6) Thet Iha DISTRICT recommends Installetlon ol a pressure reguleiing velve. Applieant acknowledges Informetion as to Ihc
<br />recommeniellon and eseumes full responsibllity for fnstellfng or lelling to install a pressure regula�ing value on Ihe welar system t�
<br />P�o��� It Rum hlgh pressure.
<br />.�NT qv�,2 (7) Tho DISTq�CT ullllzos chock valvee at iha meter to prevenl waler returning to the Diatrlcls mains. Tha DISTRICT reeommends
<br />��j . Installallonolathermalexpenslontenktoprevenlatees�ivepresaure6ulld•upeauaedbylhewaterheeter.Applicantsacknowledges
<br />' � informetlon as to Ihe ron.mmendetion and aacumes full responsiblity for Installinp or felllnp to Install a thnmal ezpanslon tenk.
<br />�\ ,
<br />SERVICE ADDR[SS: i'�� ��_ � n� �� �` "
<br />CITY/STATE/ZIP: �+�£ ,�. .� ���� G i � 1 r/
<br />�7 „ 7x v
<br />OWN'cR'S NAME: / ; � ,, •; 1 �
<br />' i � � ^ ,_,r- - „
<br />OWNER'S ADDRESS; � � -i � • .,�; h ,, �G
<br />CI7Y/STATE/ZIP: "'✓—� , _ � _ �y,
<br />Tho premises are to bo used as a���'�r �
<br />�� — �i
<br />.- „
<br />LOT NO. �v> •�—, ;' � i —� BLOCK �_
<br />PLAT NAME: � J �
<br />�%'1� �'� �c��_i�i!i / .
<br />IEGAL DESCR�PTION:
<br />INFORMATION LET7ER-GAVE/8_NT: Z��� _
<br />CHARGES:
<br />(1� Service instatla6on 8 connection charge 5_�'i 1! �`�`'
<br />(2) Genenl Fadlitios cannoeGon chargu $ C' "� /� ��
<br />(3) Othoi � �
<br />Total amount mceived wilh ppplip6on S- �—� � �'�
<br />ITIS UNDERSTOOD that ihis Application, allhough si3nad, shall not ho binding upon the MUKILTEO WATER DISTRICTuntil approvedby the DISTRICT!'''
<br />I, Iho undersigned, ownor (or represantr,tivc) ol tho property dascribod ebovo, do hereby make applipGon for inslalla6on ot a
<br />diameter wuler supply servico connectlon, including appunonances, and all noeossary labor at my expensos. ����
<br />Dated this _��t_` day of ll ,��,? ,
<br />.19 C ,�_ .
<br />APPLICANTS SIGNATURE: �?_�' ^_ .. _.:�I �
<br />4pplicanPs Nama (ploase pnnq: � ,� J J � 7- n
<br />I i
<br />����pplicanl's Address nnd Phone Numbar. - -, �
<br />- - �: , <„ � � o
<br />APPROVE�:
<br />MUKILTEO WATER DISTRICT
<br />aY: �Date:
<br />PAID
<br />A P R 12 1990
<br />MUKILTEO ViRTER DISTkIC
<br />
|