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6825 SKIPLEY RD LINE 5 2016-01-01 MF Import
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SKIPLEY RD
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6825
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LINE 5
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6825 SKIPLEY RD LINE 5 2016-01-01 MF Import
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Last modified
3/29/2017 8:56:46 AM
Creation date
3/29/2017 8:32:33 AM
Metadata
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Template:
Address Document
Street Name
SKIPLEY RD
Street Number
6825
Tenant Name
LINE 5
Imported From Microfiche
Yes
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�/ , I � <br /> � <br /> PRY AGREEM�HT <br /> I <br /> I <br /> � The undarsiQned hereby reVu.ests the City oY Everett to waive <br /> the PRV charge on is/her ater service at <br /> � ��y� $� �%l�> (�E�� U�� <br /> __.�fClL�------ f�--�- The underaiined <br /> � T <br /> � represents thet the service nt said 1p�ati Qn pres�ntly ha�s a PRV <br /> I � �hte�.�i fb ��+�f�s1A q YRV v� M�� 30 �7cy � ,� <br /> i in Qood working order ,� and that, in conaideration ot vraiver';�� <br /> � <br /> � said charQe, for the period that underaianed is a water service <br /> � customer a„ the above location, the undersigned aerees: <br /> 1 . To maintain said PRV in good workina order; and <br /> 2. To release the City of Everett from any and all <br /> liability arising Prom increaaed operatinQ presaurea on <br /> the �5 transmission line to Which the above water <br /> service is connected; and <br /> i 3. To indemnify and hold harmless the City of Everett Prom <br /> any and ell cleim� related to the Yailure of the PAV <br /> � installed at the above location. This indemnity is on <br /> � behalf oP the undersigned, and the undersigned agrees <br /> j to notity the city of Everett ot any change of <br /> Ios+nership of the Water aervica connbction at the above <br /> � lo�ation. <br /> i DATED this ��day of =7 e� � � �• <br /> I � <br /> ��� - <br /> STATTs Or WASHINGTON) <br /> � � �`sa: <br /> COUNTY OF�bt�. -�+'T <br /> I certify that I know or have satisfactory evidence <br /> ' that _.��� u ✓c ¢.. 4__���'"..`� `_��4 �a sienad i.his <br /> � <br /> � i»strument and acknowledged it to be (i►#e-;-fi�er, their) Pree <br /> � <br /> I and voluntary act for the uses and purposes mention in the <br /> i <br /> I instrument. <br /> � (/G,�/ <br /> I Dated: / ' � / / o �,----- <br /> I . . <br /> I (Seal or Stamp( Signature oP Y - -+ <br /> Notary Publ c: -< <br /> � Title: � - -- — <br /> I � <br /> i My commission exp�res: �_— <br /> � <br /> i <br /> � <br /> ; <br /> 'I <br />
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