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5102 FOBES RD LINE 5 2016-01-01 MF Import
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FOBES RD
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5102
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LINE 5
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5102 FOBES RD LINE 5 2016-01-01 MF Import
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Last modified
9/15/2017 8:05:10 AM
Creation date
3/7/2017 1:10:59 PM
Metadata
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Template:
Address Document
Street Name
FOBES RD
Street Number
5102
Tenant Name
LINE 5
Imported From Microfiche
Yes
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i <br /> � <br /> , , <br /> . � <br /> ,� <br /> PRY.�S�BEEI�KT <br /> Tha nndersigned hereby requesta the City of Everett to waive <br /> � the PRV charge on his/har water service et <br /> �� f /_ - - D, �v�.,��f' �f�',2D� The underaiQned <br /> irepresents that the service at said location presently has a PRV <br /> Iin Qood workine order and that, in consideration of waiver of <br /> said charQe, Por the period that underaiQ{�ed is a water service <br /> Icustomer at the abova location, the undersiened agrees: <br /> 1 . To mnintain said PRV in good workina order; and <br /> 2. To release the City ot Everett 4rom anY and all <br /> liability arising from increaaed opareting preasurea on <br /> the �5 transmission line to Which the above Water <br /> . I service is connected; and <br /> � 3. To indemnify and hold harmleas the City of Everett from <br /> any and all claims related to the Pailure ot the PRV <br /> ! inatalled at the above location. This indemnity is on <br /> � behalP oP tha undersignad, and the undersi6ned agrees <br /> I to notiYy the city of Everett o1 any change of <br /> , ownership oP the water service connection at the above <br /> � location. <br /> i DATED this �� day of � ' 1987. <br /> � .-ee-,�-�(i <br /> T- <br /> STATE OF WASHINGTON) , <br /> J 58� <br /> COUNTY OF A2� <br /> I certily that I knoH or have satislactory avidence <br /> that � �eue�w � __��.� signed this <br /> I instrument and acknowledged it to be (}}�s,�r, hei ) Yree <br /> i � <br /> � and voluntary act for the usas and purposes mention in the <br /> i <br /> Iinstrument. <br /> Uated� --�- S-� ------- <br /> (Seal or Stamp( Signature ot <br /> Notsry Public: — �- <br /> ITitle� �y�'����'� <br /> � My commission expires: �"��D <br /> � <br /> i <br /> i <br /> � <br />
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