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___ „ i , <br /> • � - RECEIVEt) <br /> ; <br /> SEP l li �`!n/ <br /> �R� ��g��M��� UTILITIES DIV. <br /> The undersiQned hereby recluests the City of Everett to waive <br /> ithe PRV charge on his/her Watar service at <br /> __���_��o �� RC?�e_Y�"��JL�. The undersigned <br /> i <br /> ; represents that the sarvice at sa+d location presently has a PRV <br /> Iin 600d working order and that, in consideration of waiver of <br /> � <br /> � :�aid charge, Por the period that undersi�ned is a watar servi ce <br /> Icustomer at the above location, the undersiBned agrees: : <br /> 1 . To maintain said PRV in good working ordar; and <br /> 2. To release the City of Everett from any and all <br /> liability arising Prom increased operating pressure5 on <br /> the �5 transmission line to which the above wa�er <br /> . I service is connected; and <br /> J 3 anyiandmnall claimsldrelatedsto htheifailureVofethe PRV <br /> � installed at the above location. This indemnity is on <br /> � behalP oP � the undersigned, and the undersigned aBrees <br /> � to notify the . city of Everett of any change of <br /> i ownership oP the water service connection at the above <br /> location. <br /> ! DATED this _��day of �_e�'�e�"='�-e �� 1987. / � <br /> . � _ �_ --� <br /> I G� <br /> -r-- ---- --- <br /> STATE OF WASHINGTON) . <br /> �. � � s: <br /> COUNTY OF l nch�11 � <br /> I certiPy that I know or have satisfactory evidence <br /> that __��rr'^O`—�' -S���'Y�=`---- signed this <br /> � I f ree <br /> � I instrument, and acknowledged it to be (�r her, �.) <br /> , � and voluntary act for the uses and purposes mention in the <br /> � instrument. <br /> ' .I a'Dated: _�Q.��.�..-19�------- <br /> !� <br /> I (Seal or Stamp( Signature of i J��'-j`t �� <br /> Notary Public: <br /> . I T i t le: _ --------------- <br /> I <br /> My commission expires: _,_ -- <br /> � <br /> i <br /> : ;I _ <br /> � <br />