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Application No. <br />Ivleter Size _ <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COIJNTY WASHINGTON <br />APPLICATION FOR WATER� <br />_ �� <br />Number of Units <br />No. �i.l ' "� <br />AccountNo. ��� a��63U:J� <br />I hereby appiy for water service and agree to be governed in accordance with the resolulions, rules and regulations oi the <br />I�AUKILTEO WAT�R DISTRICT pertaining to water service, now or hereatler in effecL The undersigned as owner or <br />representative oi the herein-describer� premises hereb;i agrees as (ollows. <br />(1) That the cost of any extension cf the water service, renewal, replacement or repair to r3och und serve the properry descnbed shall be bome <br />hy mysctl or assigns as owncr (s) of ihc p��:m�ses. <br />(2) That al; pipes, water measuring dovices anc' at`�erconnoctinQ equipmont upstroam trom ihe molar shall, attorthoirinstallation, be antl bewme <br />the pmperty of the NUKILTcO WAT'cR DISTRICT, subject to all iis reaulations portaining to water service. <br />(3) That alter instailation, il mmer or moter boa aid appurtences aro 6uned or damaged, the owner, will bo hcld responsiblo and chargod lor same. <br />(4 ) 7hat tho MUKILTEO IYATeR DISTFICT, its ot(wrs and ogonts, shall haw thu riaht of ingress end egress to go upon tho premisos and p�operty <br />desaibod herein for the purpose ot inroection, wnnocting or disconnecting Iho sorvico or for such ather purposos as the service may require. <br />I; is alsu understood during tho time tha. any ol tho water mains may be out of service by mason of any emergency or improvemanls autnorized <br />hy tho DISTRICT, in any street or other I�calion in which thoy may have lwon laid, iho DISTRICT will not be requimd to Wmish watcr during <br />tne progmss of such impmvemonts to any consumor whose supply mey thus be cut otl, or M liable for any damagos tor its faiiure lo do so. <br />(5) Thnt tho DISTRICT shall hava Iho right to change the ratos at any time Gy RosoWtion, to tomporarily dlscontinue Ihe wrvico to consumers, and <br />to install the moter (s) to repister the water consumod. Tho DISTRICT shatl nm be hald liablo for damage by waiororothor causo resulting trom <br />dolective plum6ing or applianxs instalied by tne ownor or ocwpant on Iho promisos suppliod with wator, and :ho fc�t thatagents ol the DISTRI CT <br />may have inspocted ihe piumbing nnd appliancos shull not bo plead as a basis lor rocovory in caso ol d�mage as ebresaid. II the supply ot <br />water shall lail or be interruptod by reason of accident, low pmssura or olher cause whatsoevor, the DISTRICT shnll not bo held liable lor damages <br />no; shall such lailum or interruption Icr any roasonable time bo held to constitme a breach of eontrad on ihe patl ot the DISTRICT or in any way <br />mlieve iho consumar, whcther �enant or ownor, Irom podorming Iho ohligation ol such tonanYs or ownor's eontrect. Weler shall bo usod by <br />appliwnt only on tha promises desaibed horein. A now applica6on shall be filed shauld water be dosirod lor othor promisos allhough located <br />� on land desaibed herein. <br />ir,r ��� �(G) Thnt fhe DISTRICT rucommends Installatlon of e precsuro regulaling velve. Applicent acknowledges Informatlon es to iha <br />recommendntlon and assumes lull respanslbllity lor Instulling or felling to Insteli e pressure reguleiing value on the wator system lo <br />prmect It irom high ptessure. <br />r;- �(7) The DISTRICT utilizes che�k valvea et �he melar to prevanf waler returning to the Dlctrlcls melns. The DISTRICT recommends <br />� InstnlletionolethermelexpensiontenkloprevenleYoessiveprasaurebulld•upcauaedbythewaterheeler.Appllcenteaeknowledpe� <br />� tnlormelio� es to tho recommende�Ion and eesumes lull responslbllty lor Inetellinp or telllnp to Inetell a Ihermal expanslon tank. <br />SEFVICe A�DP.ESS: `�'�` -'�� �� "-- LOT NO. = ' � BLOCK <br />.. � PLATNAME: ::�<.:.y (Il��ILa:i�G <br />CITY/STATE2IP: �- ✓` I'� �~� <br />OWNcR'S NAME: / i ; ��%�,-, <br />OWNER'S A�DflESS: ��`i.;^i;^ F:%: • :1 i. /.i..`'. <br />CI1Y/STATelLIP: �-!�� � �. " " ��=j �. <br />L'cGAL D'eSCRIPTION: <br />T%' i�7 <br />The promisos uro to bo usod as n -✓�'� � � <br />IN'rORMATION LE77EF-GAVE/SENT: �� ,��' <br />CHARGES' <br />(7) Servi�e installation d wnnoction chargc S� <br />,'J�`�' i�✓ <br />(2) Ganoral Fucilitios connoaion chargo S <br />,:7�/--� ��'-' <br />(3) Other 5 <br />7otal amount rocoivud with applica6on� 5 �J �� ��' � '�� <br />I i I.^ UN�ERSTOOD that this Appliation, althouph signod, shall notbo 6inding upon tho MUKILTeO WATER DISTRICTuntil approvod by the DISTRICT. <br />I, the undersignod, owno: (or represenWtive) ol tho property descnbud nbovo, do heroby meko appliwtion lor installa6on ol e <br />diamoter wator avpply sorvico connection, includ�ng ap,punenances, and all nocessary labor at my exponses. <br />Dated this :'� da�2t� ; � �;, ,/ -: \ , �� . � ' ;�� <br />.1PPLICANTS SIGNATURE: <br />ApplicanCs Namc (ploase pnnt): � <br />Appli��nt's Address and Phono Number:= <br />APPROVED: <br />MUI:ILTEO'4�ATER DISTRICT <br />ej /�s/; <br />� <br />����yi.�—� ` �t�tL <br />\ �-\C,C\�k <br />o. ��� "�= cs,�F .�J� � �- �t r+ �� — AUG 1 5 2000 <br />Date: �/i / Oa.� <br />-inch <br />WNT�R DISiRICT <br />� <br />♦ <br />w <br />