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v <br />/J _ ACCOUNT NO. C Z'�J5> / cj0. <br />l,PPLIChT:ON WO.--_! <br />�t <br />MUKILTEO WA?ER LUISTRICT <br />SNOHOMISH COUNTY. WASHINGTON <br />2�1 <br />APPLICATION FOR WATER <br />�-�� � <br />Mukil�eo, Washington � . 19 � � <br />T� 7N£ SU?ER!KTEKDENT OF THE tdUf:ILTEO WhTEP. DISTRICT: <br />I hereby apply (or !he use o! water in accordance wilh the rules and regulat:ont ol <br />;hc Mul:iltco Waler Distnc�. <br />During the lime that any of the w�te: mains may be taken up by reason ol an� im� <br />provement authorized by ihc Uist:ict ir. o: o! an}• street, road or clley i.� which the; raay <br />nave been la�d. thc DisLict w•ill na! be rcauimd to furni.h waler da:ir.q ihe p:oaress o; <br />r.u:n inF�oveme�l[ to any consumc wi�o::c oupply moy thus �e cut of!, o: be liaule lor <br />am� damagc lo: its lailure so lo do. <br />9'hc o�encr xhall bc !iablc for an)• datnagcs to thc scrvicc connection. <br />PROPf RTl' <br />� <br />J !' ��i.�- .5 -;�� <br />nv�aess: ��'� 3..Z o�'F-G�...c-<<-e�-:�-�C. Qi*-�� <br />_� <br />State c¢e o; ser.ice r .inch <br />$/�G, �C has been received wi1F lhis applicatior. <br />" ::emises cre to be used as a���� �rLL-- n'""�--L�-�'^ �' `�`�'� <br />���1 �, / <br />✓ v � <br />�,. . owne: of �h= premises is �C� -�-�'�'l�- 7� <br />Tie aoen;i; <br />The Diatricl recummends inslallatior, oi a p:essvte regulaling valve. <br />Applicant acknox•ledges in!o:matian as to the recommendeticn and ... <br />nc-ee; to ins�v p:ecsure re��tating valvc <br />Sgacd <br />Dedines to install a ptessure regulaling valve <br />Sir.ned �-- <br />1� is underslood that all connections, includinF metec and meter box shall [emain Oic properip of <br />\fuAihyu�jl'a �r 5i�t. �, <br />r Signed� .:�!`-�� /i ..[/-4f—� , Ownc <br />,� . _ l. -, ��O,�i 7 7C / �C t-l�+-aa.v ''�fa�-� <br />hadress <br />_.._ �, u:-c_s.c_z�- —�p�c3 <br />IJ�UI(ILTEO 11'P+TEt� DIS�a. � ha�nt <br />Rddre=_= <br />TOTAL MATERIALS COST � �^(.' <br />FO� OFFICE USE ONLI': <br />DF.TE COMPLETEO — �_�F----�- � b 3-----"� � <br />POST 70 ACCT NO. C�-l�y5 `t y.�S ____ _. <br />_--�� % 3 7�---_. <br />__ G.G [--- �- �l � --- <br />