Laserfiche WebLink
� '�, � ' � o <br /> '� ` MUKILTEO WATER DISTRICT � <br /> SNOHOMISH COUNTY WASHINGTON � <br /> APPLICATION FOR WATER ^'' <br /> APPi�cation No. � No. ���/� �� <br /> Meter Size � �� Number of Units _� Account No. �'�— ��-3�� � <br /> I hereby apply tor water service and agree to be governed in accordance with the resolutions, rules and regulations of tt�e C <br /> MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in ei(ect. The undersigned as owner or � <br /> represent2tive of ihe herein-�escribed premises hereby agrees as(ollows: �l <br /> (1) That tho cost of any eztension ol the water sor�ice,renetm�,replacomont or repair ro roach and serve the properry descri6ed shail be home � <br /> bp myself or assigns as owner(s) of the premises. <br /> (2) That all pipes,wamr measuring dovices and other connoctin6 oquipmont upstmam Irom the moter shall,aftortheir installation,be and bewme �( <br /> the proFwrry ol Ihe MUKILTGO WATcR CISTRICT,subjoct to all its regulaGons{.ertaining to water service. � <br /> (3) That after instaliation,if moter or meter box and appurtences are buriod or damagod,tha ownar,will be hold rosponsible and cherged for same. � <br /> (4) ThatihoMUKILTEUWATERDISTRICT,itsoffiwrsandaponts,shallhavethorighlafingressandegrosstogouponthopremisesandproperry <br /> describod heroin br the purposo ol inspection,connecting or disconnec6ng tho service or lor such other puryoses as the servico may require. <br /> It is also understood during thn pmo ihat any of the water mains may be out ol service by reason ot any emergency or improvements authorized <br /> � by 4io DISTRICT,in nny streot or othcr location in which�hey may have heon laid,the DIST�tICT will not be required ln lumish wator during <br /> � tho progress ol such improvoments to any consumor whoso supply mey thus be cut oN,or bo liable for any damagos for its failure to do so. <br /> (5) That tho DISTRICT shall havo Ihe nght to chango lhe r2tos al any limo by Resolution,to iomporarily discontinue lhe sorvico�o cnnsumers,and <br /> toinstallthomatcr(s) roregismrthew�lerconsumad. ThoDISTRICTshallnotbahoidliabletordamagebywalororotherwuso�nsultingtrom <br /> doPoctiveplumbingoraopliances' stallodb��hoowneroroccupantonihepromisossuppliodwithwator,andthofactlhatagentsoftheDISTRICT <br /> may have inspecled tho pl�mbin nd oppfances shall not be pload as a basis tor recovory in case of damago as aforesaid. It the supply ot <br /> wntershallfailorbeintertuptedb reasonolaccidonl,Iowpressurocrothorcausowhatsoovor,lhoDISTRICTshalinot6eheldliablalordamaaes <br /> nor shall such failure or iNerruption lor any roasonaSle time be hold to eon:tiwm a breach of eontract on the part oF tho DISTRICT or in any way <br /> � rolieve Iho consumer,�vhrAhur tonant or ownor, Irom pedorming tho obligation of such tonanYs or owner's centract. Wator shall bo used by <br /> applicant anly on the promisos doscribod horoin. A new application shall be lilod should waler bo dosaod for other premisos although located <br /> on land drscribed hercin. <br /> iNi� (6) That Ihe DISTRICT recommends Installalion of a pre^.sure regulatfng velve. Applicanl ucknowledgos informntion as to the <br /> recommendatlon nnd assumes lull respens1611I1y(or fnstalling or falling lo Instoll e prossure regulating value on lhe water system lo <br /> pro�ect It irom high pressure. <br /> ;Nr _(?) The DISTRICT utlllzas check vaWes et the moter to prevent water rewming to Ihe Dlstrfc�s melns. The DISTRICT recommends <br /> Inslalle�lon of a thermal erpenslon lenk to provent excessive prossu re 6uild•up ea used by ihe waler heater. Appilcenis ecknowledges <br /> � ^\' Inlormulion es to tho recommendntton end assumes lull responslbllty lor installing or talling to Install a Ihermal e:panslon tenk, <br /> SERVICE AODRESS. l�l�� S/ /JiC • LOT NO. ��/� �---�`G—� <br /> ..'' I317- PLAT NAME:�• � � ��7'� ��• /��" 3 <br /> CIN/STATFJZIP: /�t / , �Q • �7 �� LEGAL DESCRIPTION: Z� f{a�— <br /> OWNER'S NAME: L ��� l�/f/� <br /> OWNER'S ADDRESS: � • 2 �f� <br /> CIN/STATEIZIP, ���� �_���/��� <br /> Thc premi s arc to b/o fusod as a <br /> ��,�rw.AYL--rL INFORMATION LETTER-GAVE/SENT: . <br /> , �� CHARGES� PAID <br /> (1)Scrvicc installation 6 wnnection chargo 5 1�//���/. � vI, <br /> (2)General Facilities connoction chargo 5 _--! b � b • �L JUN 011993 <br /> �s�oin�� s � 0 �— MUKILTEO WATER DISTRICI <br /> Total amount recoived uiith appliwGon 5 <br /> IT IS UNDERSTOOD Ihat Ihis Appliwlion,a�though signod,shall not bo binding upon the MUKILTEO WATER DISTRICTuntil approwd by thc DISTRICT. <br /> I, the undersignod,owner(or representative)of the pmpeny doscribed nbovu,do hemby mnke appli:ation tor insWllation of a ��� -inch , <br /> diamater watur supply servica connection ' luding appu enances, and all necessary labor at my ezpanses. �• <br /> Da!ed this _� day of ,19 ,�_�_ � <br /> APPLICANT'S SIGNATURE: <br /> f,.p:icanCs Namc`(plcaso print . � � <br /> ... ApplicanPs Address and Phone t�(umbor: • ' 3 � 9 y <br /> APPROVED: ����f �ZA A(C �-Ol� <br /> � MUKIL/��NATER DISTRICT <br /> / � <br /> gy�,/ � �'l�`�`� Date: <br />