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Applicalion No. � ���
<br />Meler Size �/�'
<br />MUKILTEO WATER DISTRICT
<br />SNOHOMISH COUNTY, WASHINGTGN
<br />APPLICATION FOR WATER
<br />�iv
<br />Number of Units _
<br />No. "1%I /L�.t v�
<br />Account No. d�`� �'27��04
<br />I hereby apply lor water service and agree to be governed in accordance with the resolutions, rules and regulations oi the
<br />MUKILTEO �VATER DISTRICT perlaining to water service, now or hereafter in effect. The undersigned as owner or
<br />representative of ihe herein-described premises hereby agrees as tollows:
<br />(1) Thit tho cost ol any extension of tho water sorvico, mnewat, repiacamont or repair to roach and servo tho proporty describcd :hall be bomo
<br />by mysell ur nssigns as o�vncr (s) of the premisos.
<br />(2) That all F'�ls, watcr mcasuring dovicos and o�har eonnocting oquipmont upstroam Irom the motcr shnll, al:or thoir Installation, bo and becomo
<br />the proporry ..t tho '.IUKILTEO WATER DISTRICT, subject lo nll its regulaGons portaining m water sorvico.
<br />(3) That alter installation, it meter or metor boz end appurtoncos aro buriod or damagad, �ho ownor, will bo held rosponsihla and ehargod lor samo.
<br />(4) Tha� iho MUKILTEO WATER DISTRICT, its of�cors and agonts, shall have tho righ� of ingross and egross to go upon tha premisos and p:operty
<br />desuibod horain lor �ho purposo of inspection, eonnecting or diseonnecfing iho sorvico or br sach othar purpor.os as thu sarvico m�y requim.
<br />It is also understood during �ho timo that any ol �ho wa�er meins may be out of service by reoson of any emergency or improvements authorized
<br />hy tho DISTRICT, in any sheot or other location in which Ihey muy have baen laid, the DISTRICT will nm bo required to fumish water during
<br />tho propross ol such improvomonts to any consumer whose suppiy mey thus be cut oH, or 60 liabin for any damagos for its failura to do so.
<br />(5) That tho DISTRICT shall havo tho right to chnnge tho retos et any tima by Rosolulion to tomporarily discontinuo tho sorvico to consumers, and
<br />toinstallthomota (s) torc9isterlhawaterconsumed. ThoDISTRICTshallnotboholdliabiotordamagoby�warororotherwusomsultingimm
<br />dofoctivo plumbing orappliances installed 6y �ho ownur oroccupant on tho premisas supplied with water, and iho tact that agenls ol tho DISTRICT
<br />may havo inspocted tho plumbi�� and apptiances shnll not bo pload as a basis for rocovory in caso ol d�mago as aforosaid. II Iho supply of
<br />water shall izil or 6e interrupled by reason ol accidont, low pressuro or othoreauso whalsoowr, iho DISTRICT shall not bo hald linblo for damages
<br />nor shall such failum or intcrmption lor any ronsonablo timo bo hold to wnstituto a broach ol contract on ihe part of �ho DISTRICT or in any way
<br />roliove tho consumor, whether tenant or owno�, Irom porforming �ho obligation af such tonanfs or owner's conuact. Wntor shall bo used by
<br />applicant only on tha pmmisos desuibed horein. A now npplir.ation shall bo �ilod should waror bo dosirod for other promisas although located
<br />on land dnsuihed herein.
<br />iur ��� _(6) Thel tho DISTflICT recommenda Installellon of a presnure regulaling valve. Appllcent ecknowledges Informallon as to the
<br />� recommende�lon nnd assumos lull responslbllliy lor Installing or lel�ing lo Install a preesure teguleling value on lhe weler sys�em to
<br />`�; l� prolect It Irom high pressure.
<br />iNT � (7) Tho DISTflICT utillzos check velvos at the meler to prevent r.aler roturning lo the Dlatr7cts meins. The DISTRICT recommends
<br />% InstallatlonolathermelexpenslonlenklopreventeKcesslvepressurehuild-upcausedby�hawaterhealer.Appllcantsacknowledges
<br />Inlormotlon as to the rocomr�endetlon and aesumes lull teeponslbllly (or Install�i/np or) lelling to Inetell � thermel expanslon Iank.
<br />SERV CE ADDRE(S�S: / ��-i/l(" I! �\ � ���L' !„ � V�� �.f� �/��I U� L�- � /
<br />� l , � LOT NO. - BLOCyK- y
<br />� .�I � L� hJ . , _ i � PLAT NAME� I I �'.� �� � . � � � ��l ��! �.J
<br />CITY/STATEIZIP: ' �% ��-
<br />OWNER'S NAME: .�:-C -k� '
<br />O6VNGR'S ADDRESS: ���
<br />CINISTATE/ZIP: L� tr ,�
<br />Tho premises nro to bo used as n
<br />ivrT-�ti
<br />LEGAL DESCRIPTION: �
<br />_..k;) l i1 �-�0� � � �� X- ��oL��
<br />— INFORAMTION LETTER-GAVE/SENT:
<br />CHARGES: - i`/ ��'
<br />(1) Serviw installation B cannection chargo S I L\(" '
<br />� U
<br />(2) Gunoral Fncilitios conneclion ehargo $ ' �C � �
<br />(3) Other S � j �, i�
<br />Tolal amount received with applicaGon 5
<br />PA1D
<br />SEP 1 1 1997
<br />MUKILTEU WATER DISTRIC
<br />I i IS UNDERSTOOD tha� this Applica0on, althouph signed, shall nat bo binding upon tho MUKILTEO WATEF DISTRICT unlil approwd�yjt179DISTRICT.
<br />I, ihe undersigned, awrrr (or represantativo�.o( Ih�o pmperty doscnbod obovo, do horoby mako oppiiwtion lor ins�allaGon of a�-inch
<br />d�.�mmer wat�r su p�y Scrvico connection, � clu .ng'appurtenances, end all �iec6s�b. ary labor at my e�pensos.
<br />Dated �his � � � day ol, � :=�.=..; . , _ ,19 �
<br />i�PPLICANTSSIGNATURE: �'r� ��' "��'" �� "-
<br />,: ,.�i,, l%r:;.,,..,, ���.,,� �;,�
<br />AppliwnCs Namo (plcaso prinl): � --
<br />ApplicanCs Address and Phono Num6er. x�' �" 1� �^, i7/✓� �c o4 �� ,
<br />APPROVED: L-���; `rl�l�,-. �,,,'.�I,i�.�-L,.� ���.ui2$✓ �`iE5 >>l'�%j�
<br />MUKILT � ATER DISTRICT
<br />gy. Dato:i�
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