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13207 THREE LAKES RD LINE 5 2016-01-01 MF Import
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THREE LAKES RD
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13207
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LINE 5
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13207 THREE LAKES RD LINE 5 2016-01-01 MF Import
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Last modified
3/29/2017 11:09:51 AM
Creation date
3/29/2017 11:09:22 AM
Metadata
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Template:
Address Document
Street Name
THREE LAKES RD
Street Number
13207
Tenant Name
LINE 5
Imported From Microfiche
Yes
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i = <br /> . ; <br /> IpR�l �GF3EEMENT <br /> i <br /> 1 . <br /> iThe undersigned hereby requests the City o4 Everett to waive <br /> i the PRV charBe on his/her water service at <br /> , o � Q�,��� � _ The undersiHned <br /> I <br /> : represents that the service at said location presently has a PRV <br /> � in Qood workin8 order and that, in consideretion o! waiver of <br /> 1 said charQe, for the period that underaigned is a wate, service <br /> cuatomer at the above location, the undersigned agrees: <br /> � 1 . To maintain said PRV in good Working order; and <br /> 2. To release the City o1' Everett from any and all <br /> liability ariaSng from increased operating pressures on <br /> the f5 transmission line to Which the above water <br /> i service is connected; and <br /> 3. To indemnify and hold harmless the City of Everett Prom <br /> any and all claims related to the Pailure of the PRV <br /> installed at the above location. This indemnity is on <br /> � behalf of the undersigned, and the undersigned aerees <br /> to notify the city of Everett of any change of <br /> j ownarship of the Nater service connection at the above <br /> � location. <br /> � <br /> I DATED this ��� day of , 1987. <br /> i � ��- <br /> _����- � <br /> STATfi OF WASHINGTON) <br /> '� � � ss� <br /> COUNTY OF �SfG�1 <br /> II certily that I know or have satiaPactory evidence <br /> . that _ ���i�l�_L f�G��__ signed this <br /> ; v <br /> � instrument and acknowledged it to be (his, her, their) free <br /> � and voluntary act for the uses and purposes mention in the <br /> � <br /> � instrument. <br /> � <br /> � Dated: =�1c�����`_ <br />
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