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14513 THREE LAKES RD LINE 5 2016-01-01 MF Import
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THREE LAKES RD
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14513
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LINE 5
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14513 THREE LAKES RD LINE 5 2016-01-01 MF Import
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Last modified
3/29/2017 12:01:33 PM
Creation date
3/29/2017 12:01:16 PM
Metadata
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Template:
Address Document
Street Name
THREE LAKES RD
Street Number
14513
Tenant Name
LINE 5
Imported From Microfiche
Yes
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, <br /> . . �. • . <br /> ; <br /> v RtCEIVED <br /> I PRV _AGR�E!l�NT SEP 2 5 1�-� <br /> UTILITIES DI�� <br /> ! The underaigned hereby reques' , the City o! Everett to waive <br /> I <br /> i the PRV charge on his/her Water sarvice at <br /> ��_��_��_�� _�QQ�jj/�Pha under�igned <br /> ; representa that the service at said location presently has a PRV <br /> � in good Working order and that, in consideration of Waiver of <br /> � seid charie, Por the period that undersiQned is a Hater service <br /> icustomer at t.he above location, the undersigned agrees: <br /> � 1 . To maintain said PRV in good working order; and <br /> i <br /> i <br /> � 2. To release the City of Everett Prom eny and a <br /> i liability ar�.sing 4rom increased operating pressures on <br /> the 7t5 transmission line to which the above water <br /> . j service is connected; and <br /> ' 3. To indemnify and hold harmleca the City oY Fverett from <br /> any and ell claims related to the Pailure �f the PRV <br /> installed at the above location. This indamnity is on <br /> behalf of the undersigned, and the undersigned agrees <br /> to notiPy the city oP Everett of anY change of <br /> ownership oP ths water service connection at the abova <br /> �II location. <br /> � D.ATED this 1�,� day of �_� , � <br /> I <br /> STATfi OF WA3HI GTON) <br /> . gs; <br /> , COUNTY 0 <br /> II certlfy that I know or have satisfactory evidence <br /> � that _�7nhnJtL_BsS€..------------ signed this <br /> instrument and acknowladged it to be (his, her, their) free <br /> and voluntary act for ttie uses and purposes mention in the <br /> instrument. <br /> Dated: se tember 22 15P.7 _____ _ <br /> �� Signature o � <br /> � (Seal or Stamp( Notary Publ �����E��'�-- <br /> ,� <br /> ;I <br /> � Title: Notar� ______—_ <br /> i <br /> IMy commission axpires: _?une i,_1991 <br /> I <br /> i <br /> II Ii <br /> � <br /> I <br /> i - I <br />
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