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, _ _ � <br /> � <br /> PR�I_A�BEEt'1�NT <br /> iThe undersiQned hereby requests the City of Everett to Waive <br /> � the PRV charge on his/her Water service at <br /> � � _ g��o S�C��O�e�k��. .rEv�r�l,��� �he undersigneti <br /> �w, � hale � n < 3odaYs <br /> � represents that the service at said location �a a PRV <br /> i <br /> � in good workine order and that, in consideration of r+aiver of <br /> Iseid charge, Por the period that undersigned is a water service <br /> I cuatomer at the above location, the undersigned agrees: <br /> � <br /> 1 . To maintain said PRV in good working order; and <br /> 2. To release the Gity oP fiverett from any and all <br /> liability arising Prom increased operating pressures on <br /> the ft5 transmisaion Line to vrhich the above water <br /> . i service is connected; and <br /> j3. To indemnify and hold harmless the City or EverFtt from <br /> I any and all claims related to the failure of the PRV <br /> � installed at the above location. Thia indemnity is on <br /> IbehalP of the underaigned, and the undersigned agreea <br /> ! to notify the city oP Everett of any change of <br /> � ownership oP the water servlce connection at the above <br /> � location. <br /> � <br /> i DATED this .�53�,day of���p�87. � <br /> I �dr�J� <br /> STATfi OF WASHINGTON) <br /> COUNTY OF�,e�r`j� <br /> I certiPy that I know or have satisPactory evidence <br /> � that �?��_�P���__�.-- signed this <br /> iinstrument and acknowledged it to be (his her their) free <br /> � and voluntary act for the uses and purposes mention in the <br /> i <br /> I <br /> I instrument. <br /> IDated: �,�,../�� <br /> I <br /> i (Seal or Stamp( Signature of � <br /> Notary Public: <br /> I Title: <br /> IMy commission expires: ,�� <br /> i <br /> i <br /> i <br /> � <br /> ,I <br />