|
�. c _
<br />Appiicalion No. ���—
<br />t�leterSize /��
<br />MUKILTEO WATER DISTRICT I�(��. J/��i�Ft�'— '"�`-' �
<br />SNUHOMISH COUNTY WASHINGTON � �i ��
<br />APPLICATION FOR WATER - ^ y- ` r GJ/, Od3
<br />No. _���� "" „' ,�
<br />Nur.�ber ot Units � nccount No. D.�?� �'� 9%30/d
<br />I herety apply for water service and agree to be govemed in accor�ance with ihe resolutions, rules and regulations ot ihe
<br />MUKILTEO WATER DISTRICT pedainir � 10 water service, now or hereafter in effect. The unde�_:gned as owner or
<br />representatice of the herein-described premises hereby agrees as tollows:
<br />( 7) Th�i the cost of any eztension o! che watsr se!viw, renewal, replacoment or repair ro reach and serve the property descnbed shall be bome
<br />by myself or asslgns as owner (s) ol the premises.
<br />(2) Tha; ail pipes, water measuring tleldces ana otherconnecting equipmenl upstroam �rom L1e molershall, alter Iheir insta�la[ion, be and become
<br />the propmry of Ihe MUKILTEO IVATER DIS i FICT, subjec; t� all it� regulations pertaining �o wator sorvice.
<br />(3) Tha; aher instaliation, ii meter or memr boA and apputlences are buned or damaged, iha ownor, will be held responsiblo and charged tor same.
<br />(4) iat�hc�dUKILTE0IVATERDISTRIC7,itsofliccrsandagon�s.shallhavethoriahrofingres6andegross[ogouponthepremisesandproperty
<br />�escribed hercin (or ihe purpose ol inspection, rannoaing or disconnocting ihe sorvice ur br such other purposes as Ihe cervico may require.
<br />II is also understnod dun�ig the time Ihat any of the water mains may 6e out ol service by roason of any emergency or impmvements aulhorizrd
<br />by the DISTRICT, in any street or other location in which thay may have 6een laid, iho DISTRICT will not be required �o fumish wa;er during
<br />the prooross ol such improvements to any consumor whose supply may thus be cut oH, or ba liab'e tor any damagos lor its IaiWm to do so.
<br />(51 That Ihe DISTRICT chatl have Ihe right lo chanpe the rates at any time by ResoWtion, t� temporarily discontinue the s�rvice to eonsumers, and
<br />ta instatl the meter (s) to rr.gistm the water consumod. The DISTRICT shall no; bo held liable lor damagr by x•ater or ether cause tasWting Irom
<br />dofectve plumbinn or appiiances in;Lilled 6y Iho owner or occupant on Ihe premises supplied with water, and the tact that a aenis ot the D ISTFICT
<br />may have inspected the piumbin� and appGances shnll not be plead as a basis tor recovep• in case ol damage as aloresaid. Il lhe supply ot
<br />wamr shall lail or be interrupted 6y renson of accident, low pressuro or other cause whatsocver, the DISTRICT sha!I not be held Iiable tor damages
<br />nor shall such IaiWro orintermption lorany reasonable time be held to wnstitute a breach of contract on the part of the �ISTRICTor in any way
<br />rclievc �h� coosumur, whethor tenant or owner, imm periorminp tha ohligation ol such tenanfs or owner's wnlrad. lNatQr shall bo used by
<br />applioant only on the premises described horein. A new application shall be liled shouid water be desirco lor other premisos allhough IocateC
<br />� on land described herein.
<br />rv; _(G) Thot Ihe DISTRICT recommends Installatlun ol n pressure regulat!ng vnlve. Applicnnl acknowledges tnlormation as to Ihe
<br />recommendnt!on and essumes Iuil rc�ponsihlllly for fnstaliing or lelling lo Inslali o pressurc regulalinp valuc on Ihe wa�cr system to
<br />ms ,�' y pro tect It Ircm high pressurc.
<br />(7) The DISTRICT u�ilizes check vaives at the rt�eler �o prevent vm�m reWming to the Disiricts mnins. The DISTRICT recommends
<br />�" installalionolalhermalexpensiontanktopreveNexcessiveprussur�build•upcausedbylhewaterhenler. Appllcaniseeknowiedges
<br />� in�ormcllon os to the mcommendalion end ossumes tul; responsibllly for InsWlling or Ielling lo Inslall e thermai ezpansian lank.
<br />S=nVIC[ ADDRESS� G�� ✓� %��, ,.il
<br />—T —
<br />---- �,� , �/ � r `"� y
<br />r ,�
<br />CITYIS'ATE/ZIP-
<br />ON'NER'S fJA�'[: "Tc. L T. //r �
<br />OIVNER'S ADDHcSS: ��=�'1 C - ' i7�T_�"1,.. .(
<br />CITI'/STATE'ZIP: � �.�..� (L„ ��� 1 t ) � � �o
<br />The premisos am to bo used as a
<br />LOT NO.
<br />BLOCK
<br />PLAT NAME: T� F l T� �Iu,n ._ ': /� . . �f //� ,- —
<br />LEGAL �ESCRIPTION:
<br />INFORIdAiION LEi7ER-GAVE/S[WT�.
<br />CHARGES:
<br />(1) Sorvico installation d pnneetion Giar�c 5 `'C�G� O�
<br />(2) Goneral Facilities connec�ion eharge S ;� ' �� C1 �1
<br />(3) O;her j
<br />," 7
<br />�� '1�
<br />DEC 12 1990
<br />Tota� amount mceiecd with uppiicauon S��'r �. �' 1� MUKILTED WATER DISTRli;i
<br />iT IS UNDcRS707D that Ihis Appiiwtion, allhough signed, shall no; be binCing upon the MUKILTEON'ATER DISTRICT until approved by the DISTRICT.
<br />I, Ihe undersignod, owner (or mpmsentative) of the property descnbed nbove, do hereby make application lor installaGon ol n � -inch
<br />diamoler wator supply servico connection, including appuncnances, and all necessary labor at my ezpensos.
<br />Dated this _____� �_(,E_ dar o� "". r..�__�=9 '7 �
<br />..�,� /.v �
<br />APPLICANT'S SIGNATURE: � :� �?�S�..q _ _ � ., -"
<br />AppLcanfs Name (please prinif: � ��� � � �� '
<br />. � ^�,
<br />Appiiaanfs Addmss and Phone Numbor: �7` � � >. �. %��-.-��_=![ �,,� y,� � �/� �Y J��
<br />__ � r � , , '
<br />APPROVED• -
<br />��9UKIL �WATER DISTRICT/
<br />��i / ,
<br />3�� �,(*�f••�1"��
<br />/
<br />/ �3�6
<br />�ate. _
<br />lG
<br />G
<br />Ir �� �17�`J
<br />��
<br />
|