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���h 8'� <br />� .14pplication No. <br />Meter Size <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />Number of Units <br />No. 9�—�oy2� — <br />Account No �%�D"/�U/�� <br />i hereby apply tor water service and agree to be governed in accordance with the resolutions, rules and regulations of the <br />MUKILTEO �.NATER DISTRICT pertaining to water service, now or hereafter in eftect. The undersigned as owner or <br />iepresentative ol the herein-described premises hereby agrees as foilows: <br />(7 � That Ihe cost ol any extension of the wator sarvice, renewal, replacement or repair to roach and serve the pmperry described shall be bome <br />by myself or assigns as ownor (s) of the premises. <br />(2) That all pipos, wa�er measuring dovicos and othor connecting oquipment upstream from the moter shall, aher their installation, be ard 6ecome <br />liie proparc/ ol ihe MUKIlTEO WATER DISTRICT, subjact to atl its regula6ons pertaining to wator service. <br />(3) That atter installation, if moter or metor box and a�punoncos aro buried or damaged, the owner, will he hold respon>ible and charged for same. <br />(4) Th at ihe MUKI LTEO WATER UISTRICT, its officars and agonts, shall have the nght of ingmss and egre. ��s tn go upon tha premises and properry <br />descrihed heroin lor the purpose of inspection, eonnncting or disconnecting the sorvice or for such othe: purposes aa tha service may require. <br />It is also undersrood during Iho limo that any of the water mains mey be out ot serviee by reason of any emergency or cnprovements authorized <br />by the DISTRICT, in any street or other locafion in which ihey may haw been laid, tho DISTRICT will not bc requirad to fumish water during <br />the progress ol such improwments to any consumer whase supply may thus 6e cut oN, or be 1ia61e for any damages tor its failure to do so, <br />(5) That tha DISTRICT shall have tho right to chanpo tho; atos at any time by Resolution, •o temporarily discontinue lhe servico to consumers, and <br />toinstatlthomoter(s) toregislerth�iwaterconsumed. ThoDISTRICTshallnotbeheldliablefordamagebywaterorothorcauseresultingfrom <br />dofacti. plumbingorappliancesinstalle�bythoownororoecupantonthopremisossuppliod�vithwaler,andlhofactthatagentsoitheDISTRICT <br />may havo inspocted the plumbing and appiiances shall not be pioad as a basia for reco�ery in case of damage as aforesaid. II ihe supply ot <br />wnter shall lail or bo interrup�ed 6y reason ol accident, low prossuro or other causo whatsoovor, the DISTRICT shnll not be held liahle for damages <br />�or shall such failure or interruption for nny roasanablo timo be held to mnstitute a 6reach ol coniract on the part ol the DISTRICT or in any way <br />.�.. rolieve tho consumer, whothor tanant or ownor, fmm pedorming the obligntion of such tenanYs or awnePs contract. Water shall be used by <br />."�, applicant only on the premisos desuibed horein. A now applicaGon shall be filed should water be dasirod lor other premisos olthough located <br />on land described herein. � <br />�r �✓� �(6) That�the DISTRICT reeommends Instellation ol a pressure reguleting valve. Applieant aeknowledges Informatlon es lo ihe <br />� "�� recommendetlon and assumes fuil responsibllity lor Instolling or lelling to Install a pressure regulaqng value on the watersystem to <br />p�olect Il Irom high pressure. <br />iNr;? �,_�7) The DISTRICT u111lzes check vnlvos at ihe meter lo ptevent watet reWrninn lo the Dlsldcis meins. The DISTRICi rocommends <br />�I Instellellonofathermelexpanslontenklopreventeceessivepreseur¢bulld•upeeusedbythewaterheater. Appllcanlsacknowledgea <br />t �' Informetlon as lo the recommendollon end assumQes full rosponslbllty lor instelling or fallin� lo Install e thermal expenslon tank. <br />` SERVICE ADDRESS: _! I�'� Z MI'JfA/..JA l. D : LOT NO. _� BLOCK � <br />CITY/STATFJZIP: — "^" � � !�� <br />OWNER'S NAME: _ �lnb�lrip A��A�1n f (�nn, ,- <br />OWNER'S ADDRESS: —�U UX �%2� ) <br />CIIY/STATE/ZIP: _,f-LL�.f11 F- I��A Cl� I)'S <br />The premises aro to bo used as o <br />� � <br />D <br />6 <br />v1 <br />PLAT NAME: <br />LEGAL DcSCRIPTICY; L7 /- S r' G�/ U� GS fi <br />_�0�-c.� /��o� / �i <br />� � �� _ <br />INFORP.IATION LEiTER-GAVElSENT: <br />CHARGES: // <br />(1) Service installa�ion 8 wnnection charge 5 �`71 � Oi� <br />(2) Genorai Facilitios connucGon chargo $ u�-� O • i1 U <br />(3) Othar 5 <br />Total nmount received wilh application 5 ��l� �`' u <br />� <br />✓ G' <br />. PAID <br />JUN 011993 <br />MUKILTEO WATER DISTRICT <br />IT IS UNDERSTOOD that this Applicaiion, although signed, shall not bo binding upon the MUKILTEO WATER DISTRIGTuntil appraved by ihe DISTRICT. <br />I, the undersignod, ownor (or represvntative! of tho propehy doscribod nbova,<lo hereby mako uppliwGon lor insWllation ol a 3�<� •inch <br />diameter water sup I servico connection, including appunenances, and all necessary labor a[ my axponses. <br />Dated this �� day ol �T��� ,19 �_ . <br />APPL�CANTS SIGNATUFE: <br />� ApplicanPs Namo (ploase prinl): ''��- ���'���. �� E"T�!'1/'�/S <br />_ IApplicanCs Address and Phona Number. `�'�=, n' `�����.,,�G� S� "� aC' <br />APPROVE . �,7��-r� ��I�� <br />MUKIL 0 WATE DISTRICT <br />9y: Date: � <br />3 <br />'s3ys � <br />