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<br />� : ? '• � 1 �J MUKILTEO WATER DISTRICT , h
<br />`0' SNOHOMISH COUNTY WASHINGTON
<br />� # ' ' APPLICATION FOR WA`1'ER�V �
<br />^�ppiication No. _�i� No.
<br />" 'Y
<br />5
<br />� Q.
<br />Meter Size _�/ ,��v1��_ Number of U�its � Account No. �— �•� ,> S'/ l L.�
<br />I hereby apply for water service and agree to be govemed in accordance with the resolutions, rules and regulations ot the C
<br />MUKILTEO WATER DISTRICT pertaining to water service, now or hereaiter in� efiect. The undersigned as owner or (
<br />representative of ihe herein-described oremises hereby agrees as tollows: \
<br />(t ) Tha; tho cost ol any extension ot the water sorvice, runewal, replacemont or repair to reach and serve the properry described shall be bomQ �
<br />by myself or assigns as owner (s) of tho promises.
<br />(2) That all pipes, water measuring devicea and other connecting equipment upstream from the motor shall, aher thoir installaGon, be und become �
<br />the property of Ihe MUKILTEO WATER DISTRICT, subjea ro ell its ragulatlons pertaining to water sarvice. �
<br />(3) That aftor installaeion, il moteror moter boz end eppunoncos ere buried or damaged, the owner, will be hoid responsibla and charged lor same. C
<br />(4) That tho MUKILTEO WATEP JISTRICT, its officors and agents, shall have the right of ingress end egmss to go upon tho premises and properry
<br />desui6od hor�in for the pu:poso at inspection, connocting or disconnae4ng the sorvice or for sueh other purposes as tho serviee may require.
<br />It is also understood during tho timo that any of the water mains may be out o( service by reason af any emergency or improvements euthorized
<br />by the DISTRICT, in any s•reot or other location in which they may have 6een leid, the DISTRICT will not be required to fumish water during
<br />Ihe progress of such imp•ovnments •o any eonsumer whose supply mey thus be wt oN, or be Iiahie for any damagos for its failure to do so.
<br />(5) That Iho DISTRICT sha!I have tho right to chanpo tho rates et any time by Resolution, to temporarily disconGnue the servico to consumers, and
<br />to install ihe motor (s) to repisror tha wator consumad. Thu DISTRICT shall not be held liablo for damago by water or othor cause resulting hom
<br />dalecUvc plcmhing or appliances installed by tho ownor or occupant on tho premises suppliodwith wator, and tho faa that agents of the DISTRICT
<br />may hav�'insp dod thepiumbi� and appliances shall not be pload as a basis for rocovory in caso of damage as alaresaid. If the suppty ef .
<br />wnter,�6all fuil�i bely(�rrapted dy}6�son of accidont, low pressurn or other cnusa whatsoewr, the DISTRICT shall not be held liahlo lor damages
<br />� nor shatl'such failure or interruption for any roasonablo Omo ba hoid to constitute a bmach of cantract on �he pan of the DISTRiCT or in any way
<br />� roliovo tho consumqr,-wj���Ff6r tenant or ownar, fmm pedorming the obligation ol euch tenanPs or owner's contract. Watar shall be used by
<br />appliwnt only on ihe promisos desuibed horein. A now appliwtion shall bo filed shouid watar he dosirod lor other promises a!ihough Ioeated '
<br />on land desaibod herein.
<br />�nt�.�_(6) Tho� the DISTRICT reeommeads Installetion of e prossure reg�latlng velve. Applicant aokn�wledgos Intormaqon as to ihe
<br />recommendellon end essumes tull responslblll�y for Installing or talling to Install e pressure regulating value on �he walersyatem to
<br />protect I� �rom hlgh pressure.
<br />�inT qy�(7) The DISTRICi utilixes eheck valves at the meter to prevent watur returninp lo the Dietrlets malne. The DISTRICT recommenda
<br />�.. installetlonola�hermelezpenslontenktopraveniezcesalvepressurnbulld•upcauaedbylhawaterheater.Applicantsacknowledges
<br />inlormetlon es to ihu reoomme�delion and aseumes lull responslblity tor Inatalling or fallinn to instell a thermal ezpandon 4nk.
<br />�� --�`—
<br />SERVICE �DPRESS: � /,].���; �/%�_. -�� �; � _//i_ LOT NO. :-r -,--. �,. � � .�%� ir D BLOCK
<br />.
<br />PLATNAME: �L17S4i�' �iZ�`7`Jr-c,� : �� : � ,�i��,, _7
<br />CIN/STATE/ZIP: �� /I, Cs�')iU LEGALDESCRIPTION: � �
<br />�'����•_� a�J�—�—�—
<br />OWNER'S NAME: �/,�"'� f i, ���o
<br />OWNER'S ADDFESS: '� - 7%%' �: f4' i Ir
<br />�,�'�. �—�'c��—�c-�—
<br />CITY/STATE/ZIP: t �, �, � .. i:� . � 6�A G' y �� '�
<br />i�
<br />Tho premises am to bo usod as a_�! �� �T
<br />� .ili
<br />--�iY✓— or"i,u,�i��/ .`T-..�.—ii7J16: �.
<br />INFORMATION LETTER-GAVElSENT: ���
<br />� '
<br />CHARUES:
<br />(t) Service installation S wnnection charge 5 ��'�• �%� �—
<br />(2) Genoral Fadlitics co.moaion chargo $ -�/' 'J�� �; '
<br />, =t c�
<br />(3) Other j
<br />Total amoun� recoived with applicauon S -%.� .� � � 1�_
<br />IT IS UNDERSTOOD that ihis Ap;.iication, although signad, shall not bo binding uDon the MUKILTEO WATER DISTRICTuntil approvod by the DISTRICT.
<br />I, the undersignod, ownor (or repmseNalive) al Iho propeny doscribed nbove, do hereby make applicaGon Por insWllafian ot a�_ -inch
<br />diameter wator suppl�� sorvice connection, including appurtonances, and ail necessary labor at my exponses.
<br />Dated this �i �T, day ol !+ � � ' / ,19 C ,. '
<br />": ✓.J/ ��—�
<br />APPLICANTS SIGNATURE: _
<br />ApplicanPs Namo (ploaso prinQ: �� - ^ � � � �'� �
<br />. ,��—c �i�/ .—
<br />,_--AppliwnPs Addicss and Phono Numbor: _�-� � �� —'� � � �_ � i �'tT"
<br />�-z---
<br />APPROVEG:
<br />MUKILT TER DISTRICT
<br />A
<br />B)': G � l� Date:
<br />PAID
<br />APR 121990
<br />MUKILTEO N'ATER DISTRICI
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