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1YT <br />INT <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />�� i �`� <br />Applicalion No. ` <br />'1 t� <br />Meter Size �`� Number of Units <br />��%�`I <br />No. <br />q�o�94 S <br />Account No. v�� a�liy % UO <br />1 hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations o( the <br />MUKILTEO WATER DISTRICT pertaining to water service, now or hereaiter in eflect. The undersigned as owner or <br />representative of the herein-described premises hereby agrees as follows: <br />(1) That the cost ol any extension ol �ho waler sorvico, renewal, replacement or repair to roach and servo tho praperry described shall bo bomo <br />by mysell or assigns as owner (s) of �ho premises. <br />(2) That all pipes, water measuring dovices and othot connocting oquipmenl upsiroam from ihe motor shall, altor ihoir installa�ion, bo and becomo <br />Ihe properry ot �ho MUKILTEO WATER DISTRICT, subjoct to all its rogulations partaining lo water sorvico. <br />(3) That a0er inslallalion, if ineler or metor box and apputlancas am huriod or damagad, tho awnor, wiil bo held rosponsibb ano charaod lor samo. <br />(4) That�hoMUKILTEOWATERDISTRICT,itsollicorsandnQonts,shalihe�,ethorightofingrossxndegrosstogouponthopremisosandpmpury <br />describad herein lor tho purposo ol inspection, connocting or disconnocGng Iho sorvico or lor such othor purposes as tho sorvico may requiro. <br />It is also ui;derstood during iho timo that any of tho watnr mains may be oul ol service by reason of any omergency or improvemenls authorized <br />by tho DISTRICT, in any sveet or o�her location in which thoy may haw boen laid, tho DISTRICT will not be required to fumish water during <br />Ihe progross ol such improvements to any consumor whoso supply may thus bo cut aH, or bo Iiablo lor any damagos lor its failuro �o do so. <br />(5) Thnt tho DISTRICT shall hnvo tho right �o chango ihn ralos at any time by Rosolutinn, to tomporarily discontinuo tho sorvico to consumcrs, and <br />to�nstall�homoter(s) toregis�erihowalorconsumod. ThuDISTRICTshallnolbohuldliablulordamagobywatororothercausoresul�inglrom <br />dalectivo plumhing or appliances installed by tho ownor or ocwpant on tho premisos suppliodwith watw, and Iho tact thnt agents of �ho D ISTRICT <br />may havo inspectod �ho plumbing and appliancos shall not bu plcad as a basis fcr rocovory in taso ot dimago as alomsaid. II �ho supply of <br />wnter shalllail or he interrupted by renson ot accidenl, �ow prassura or othar causo whatso�wr, tho DISTRICT shall not bo helJ liablo for damages <br />nor shall such lailuro or intem;ption lor any roasonablo timo bo held to constituto a breach ol con�ract on tho part ol tho DISTRICT or in any wny <br />mliovo �ho cansumor, �vhether tonant or ownor, imm pedorming lhe ohligaiion of such tonanYs or ownor's eontrncL Wntor shall bo used by <br />applicant only on tho promises desuibod harcin. A naw application shall be filed should wator bo dosirod lor oth^r premisos nithough loca�ed <br />� �� on land desaibed horcin. <br />U, 1J •(ti) Thai Iho DISTRICT tecommenda Inslalla�lon ot a preaeure reguleting vnlve. Appllcant acknowl .�s Intormatlon as to Ihe <br />(� recommendatlon and nssumes lull responsl611i1y lor Inslallin0 or lelling to Install e pressura regulaling �� alue on the water system to <br />U pro�ect It trom high pressure. <br />�(7) Thu DISTRICT uUllzos check valves at Ihe meter lo proveot water roturning lo ihe Dlauicis malns. Thn DISTRICT recommends <br />inslollo�lon ol a ihermol expenslon �ank to provnnt excessive prossu ra bulld•up caused by Ihe water heetor. Applicants ecknowledges <br />Informntlon es to tho rucommnndotlon end eas mos lull reeponal6111y lor Inslelllnp or lalllnp lo Ina�ell a fhermel expenslon tank. <br />) . � { l( �,(� _r <br />SERVICE ARDRESS: (�1.�)I I� —/�� �1 �����1 �" LOT NO. J `�! i, tl1 ID� �.� pLOCK <br />� I I �( 1" �-� _ PLAT NAME: <br />CITV/ST�TE/ZIP: �-_UE.Y���' <br />OWNER'S NAME: ���r^ ' <br />� <br />OWNER'S ADDRESS: y.�1?�( <br />cirvisrnr�rzir: L ,Y���' <br />Thu premises aro to bo used as n <br />LEGAL DESCRIPTION: <br />� ' �i <br />�J <br />INFORMATION LETfER-GAVEISENT: <br />CHARGES r. t �) <br />(1) Servico inslallation & connectian diarga $ I��, <br />(2) Grnonl Fndlitias connoc�ion chargo g I�' -'� u'l <br />(3) Othm � $ � - <br />Totat �mount received with opplinGon S I� /� <br />IT IS UN�ERSTOOD that�his Appliw�ion, although signod, shal� not ba bindng upon tho MUKILTEO WATER DISTRICT until approved 6 tho DISTRICT. <br />���. <br />I, the undersignod, ownur (or repmsanlatiw) ol iho propeny dascribed nbovo, do hem6y mako app�icalion lor insL�l!atian of a ( -inch <br />diameler w�tur suppI�!'seNifo connecGo Iqclo�ip j a�u�enancos, and a�l ro�ce�ssary labor at my ozponsos. <br />D�tedthis_ •i`=� dayof ���1 �/�-•�' �19—l--' <br />APPLICIINT:: SIGNATURE: _ <br />ApplicanYs Namo (ploaso prinl): <br />'.�z;,1:.�,.,.,� C..,,:. �.J /Js�i„i- <br />iL'.�U JJ � l i�.�� W� <br />Applic;mCs Addmss and Phono Numbor: <br />l..�.i. .1 ii;�•i� .� �. 7.�Sv;V il�i., ;i/ <br />APPROVED: , .. <br />MUKILTEO WATER DiSTRICT <br />���i ��..�_� <br />�?y •,.` ---- <br />oaia l,/ir /g� <br />.l'AID <br />/�; OCi 2 3 1991 <br />MUKILiEO WAiER DISiRICi <br />