Laserfiche WebLink
: -� <br />^ Application No. �`'� <br />� �i <br />I�leter Size <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />� /� •, No. <br />Number of Units _ Account �io. <br />� <br />� <br />qy�y� 3 � <br />�o s - �-5� �� �� <br />I hereby a�ply (or water service and agree to be goveme � in accordance with ihe resolutions, rules and regulations of the � <br />Iv1UKILTEO WATER DISTRICT pertaining to water service, no�� or hereatter in ellect. The undersigned as owner or <br />represenialive of lhe herein-described p�emises hereby agrees as follc ��s: <br />(1) That Ihe cost of anp extension of the water service, renewaL repiacement or repair to reach and serve Ihe propeny described shall be bome <br />hy mysctl or asaigns as owner (s) of Ine premises. <br />(2) Tha: �II pipes, water measuring de� xs and mharconnoctinp equipment upstream irom the mater shall, after thoir installation, he and become <br />tnc property ol the MUKILTEO WA : ER DISTRICT, su6ject to all its regulationc pertaining to water service. <br />(3) That aflc install:,tion, if ineteror metnr b�x and appurtencos are buried or damaged, lhe owner, will be heid responsible and charged Icr samc. <br />(t�ThatlheMUKILTEOVJATcRDISTR!:T,itsof(icersandagents,shallhavetherightofin�ressande�rosstogo: vnthepremisesandpropeny <br />described herein Inr tne purpose of inspection, connocting or diseonnecting Ine service or for such other purposes as thr. serviee may require. <br />It is also under^.tood during Ihe time Ihat any ol tne water mains may be out ol service 6y reason of any emeroency or improvemente. authorized <br />by Ihe DISTRIGT, in any street or other location in w•hich Ihey may haw been IaiC, the DISTRICTwill not be required lo fumish water dorin� <br />the pmgress ol such improvements ro any consumer whose supply may thus be cut oN, or be liable lor any damages for its faiWre ta do so. <br />(5) Tha; the DISTRICT shall havo Iho ngh; to chanoo the rates nt any time by Resolution, to temporarily discominue the service to consumers, and <br />to install Ihe meter (s) to register Ihe water consumed. The DISTRICT shall no; b� held 6ablc lor damage k�y w, tor or other eause resull!ng trom <br />cofective plumbing or appLances installed by the owner or occupant on the premises suapGed with water, and the fact ISat ogents of the DIS i RI C i <br />may have inspected the plumbin3 and appliances chail not be plead as a basis for recovery in case ot dama�e as aloresaid. II the supply of <br />watcr shall fail or be iNermpted by rcason o! acddent, low pressurc or mher cause a�hatsoover, Poc DISTRIC7 shall not be heid Iiable f or damapc:. <br />nor shall such failure vr werruptian for any reasona6ie time be held lo constitute a breach of comrac; on Ihe p�rt ol Ihe DISTRICT or in any aav <br />relicvc the concume �, whethcr tenant or owner, Imm perbrming the obligation ol such IcnanCs or owncYs eontracL Water shall be used oy <br />applicaN only on Ihe premises described herein. A new• applicatian shall be li:ed should waler he desired for other premises although Woated <br />on land descri6ed hcrcin. <br />nd; �_(G� That ihe DISTRICT recommends installnlion of a pressure regulating vnive. AppIIuN ucknovdedges inbrmatlun as to Ihe <br />recommendution and nssumes lull responsibllliy for Installing or IniBng to Instali a pressuro regulating valuc on the wmcr sysicm io <br />prolee� li Irom hic�h pressure. <br />irr �_. .. p) The DISTRICT Wilizes check valves nt ihe meler to prevenl waler reWming lo Ihe Dictdcts malns. The UISTRICT recommends <br />� instullalionolalhermalexpansfontonkloprevenlezcesslvopressure6uild•upcaucedb��Ihewatenc�ater.Applieanisncknowledges <br />inlormnlion as Io Ihc recommendntion and nssumes full responsibilty lor Installing or lailing Io Insia�l a Ihermnl expansian tank. <br />` �'� ���'ICE ADDRESS: ��o` / � �%y'1 ��`� LOT NO. � �� /BLOCK <br />. _.. / 7 PLl.T NAME: �%_✓!�-L �-Ci1/.-� <br />CIT�75iATEJZIP:_Y`i,�'�v - P��/�� LEGALDESCRIPTION: ��y <br />06'JIJER'S NAME: / � ���--L� <br />OIVNER'S ADDRESS: <br />CI'1^STATE2IP: <br />� <br />lho prcmi;es are Io be U5^d as n <br />---- ��� WFORNJ+TIDN LETTER-GAVE/SENT� � "l <br />CHARGES: / ��Ip <br />(1; Scrvice installation d conncction Charge � ���! • � '� ����- <br />(C! General Facili�ies eonnaction charge S� ��' 3 6'�� � F EB C$199ti <br />t3� om�r ; <br />Tota� amoum recmved wim appliwoon 5 � v�/• G� MUKILTEO WA7ER DI3TkICl <br />,' ,5 Ur:D�RS70Jp pi�� tnis Apph�inon, altnough sianed, snall nol be binding r„n thc MUKILTeO WATER DISTRICT until approwd by thc DISTRICT. <br />i <br />I, mc undersigned, owner (or repmsent�tive) ol ihe pmpeny desaibed above, do hereby maFo npplication for ins�allnno� ot a � / -inch <br />a,;unaler water pply service connecti� mcludmg appurtenances, and all nece�ssary labor at my expenses. <br />D. md this � day af ��/�'7/� �_ ,19� i <br />. J i /1�T-1— <br />A�'r :I�ANT'S SI.^,NATURE: <br />A,;,�.�::ants �am�: (plc�sc prinl�: —1:.� <br />�;:p1_,�nC; 4cid�oss and Pnone Numbc[ <br />tiPPaov- / <br />n�u�:i eo� I��C r�F D� <br />�� <br />�'�7 `�/ --- <br />� <br />o�,� z �/y� <br />- y��.� <br />s <br />\� <br />�� <br />O <br />