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�!'"� nCCOUNT NO(f,�� -��3 ��G L i <br /> �� / - -- _ <br /> hP+'iiCI.T10N 170. � ;-� <br /> �� � <br /> MUKILTEO WATER DISTRICT <br /> SNOHOMISH COUNTY. K'ASHINGTON G � 1 � <br /> R <br /> ppP4.lCATION EOR WASER .E ; <br /> - o?; . is��' - <br /> . t.:ukilteo,�'�cshington�— � � <br /> �{ 7p `}iE SiiP�FI1:TEt.D�6T OF THE 1dU1:PTE0 YrhTEA DISTRICT: <br /> i ne:ebY �?P�7' �°T the use o! water in eccr.dca=e with the rules end ceguletic.^.s o: <br /> � ' p�� t.!ukiltco Wate:Di.tri:t. �y recsoa oi ca;: im- C <br /> During the time thet enp ot the •.vatet mainc S�Seo IOQaeo: c Iey in whici ihey :aa? <br /> ' '�..pmvement auCnorixec b}• t'ne Listrict in or o� °D� mc thu; be cu' ol(. o: be licble Sar <br /> 'have been Icid. thc Distrmt will not hc requirec lo lums� wate: du:ing Cne p*og:ess o: <br /> .uch imP'p° lo•cilsyfcilu•c so to•do.mC1 v:h�sc supP�Y 5� . <br /> any dama9F - <br /> � Thc ownct shall b• ��hlc (or an)'aamagcs lo lhc scr���c connection. _ <br /> � PROPLRTY DLSCIclM10N: �� � � j <br /> � �� � �•ti. K <br /> ���',.(2�✓.,�C.c�� <br /> � / . %n„ ,� f�/�'.Cc� ' — <br /> :,DDRESS: �: , <br /> / �� inch <br /> Stele�ixc c:scrvice— , . <br /> '� /ya2Q•/1/1 hec been received with this app�icatlon. � <br /> �p��p;c^ises c:e to be used cs c.__�,C�������'� <br /> . -�Si-?� _ '�---- <br /> ;he oa'ne:ot ine p�emises is <br /> Sn A gent is „t,�. <br /> d./�� �-l�r�'li.�'� "��f`2C� C/� ressure regulating velvi. <br /> � qne�p¢Liq recomrends ir..tcliat(on of c p , <br /> i�pplicent acY.nov:lecge:, i:domatvalve� \o ihe re:er..m^-��atior. o: a . <br /> ng;ees to instnll c precsu:c re9ulating ---- --_ __ <br /> SiGned <br /> �• Dedines to install re�su:c regula ng valvc . - -- <br /> � ,�, .(� •�—__. <br /> ' Sipned�/T . <br /> i - <br /> � <br /> It is unArtsluod ihal all �onnections,�ncludi�F metex and melet bnx s�3l1 r�m�in th=P�oP��t>'n <br /> '��pfu{:iltcc N�atr. Distsict. � ���� <br /> /���� 7. , Ovrnc: <br /> !� .�. 1 � SianeZ✓ . <br /> ��L, � ,u�- Sy!.=- <br /> hdZress� Q <br /> . .� . .�r.,;� „�- ' ( �v'-G�. ngent <br /> .. �"F ., ,.L �.�,• q/ <br /> _ �" B•;� <br /> ti <br /> . 3 "''ll�l.i[G VdAT:� :1:T�dcrecc <br /> .33 7=s'(os", — <br /> Ci�. 3r) f <br /> TOTAL MATERIALS COST ��!� a / <br /> FOR OFFICE USc ONLY: TOTAL <br /> DATE COMPLETED _. _ . ADD <br /> POST TO ACCI" N0. _ _ _— TOTAL' <br /> CUSTO <br />