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„ <br />hP?LIChTtOt4 1J0. I� I_ ' ACCOUNT NC ���G_IS �"��L <br />� MUKlLTEO WATER DISTRICT <br />SNOHOMISH COUNTY. WASHINGTON <br />��� <br />APPL[CATION FOR 1KATER <br />lo•2s `�'3 <br />Mueillec. Wasningtor —_ . 19= <br />TO THE SU?ERINTEIdDEt7T Oi T4E tdUF:ILTEO V'hTEfi DISTRICT: <br />1 hereby appi� io: ihe use o! wme: in accordance v.•ith Ihe rules anc :egulationc o: <br />Cne tdul:ilteo Vlater Disl�ict. <br />Luring the time inat any o: th� waler main� may bc tcker, up by reasoa c! anr im- <br />provement autnxized 'ny the DisL-ict in o: of anp slteet, road or alley in which tncy rt:ey <br />hvve becr. lai�, tne iisvic! wili not be requitec tc iumish watc durinq the Frog:ess ol <br />cuch improvementc Ie a�y conwme: wnose supplr r.iay tncc �e cut off, o: :��_ lieble lor <br />cny dcmagc lo: i!s iailu: e;c lo do. <br />The owuet xhall bc liable (or an)� damages to ihe setvice wnnection. <br />I � <br />I'Y.OI'ERT1' DLSCRIP'['IOh: ^DT �-'�-� <br />� Cl�i, �.�, ihti� (�1,` Ct-'--c_f 1� I'✓ .�2 <br />l'L. <br />hDDR�55: � �' � '� � I � � <br />St�te si-� p! s�:vice _ � `-I —incn <br />� 7l S. ClQ has beer. ;eceived wit^ ihl� applicciior.. <br />� � �. <br />Tnc premise, are to b� used as c ,���^ ��=�'= �'ti?� <br />; he ov: ne: o.` th� premis^s is ��- �1�=:"�--� ��� <br />Tnc aqeat is <br />Tne Gictid reccmmendc ir:nslimior. oi c prescu:e :eaulo'�ng valvc-. <br />Anplica�t ❑ckno�.vledaes mi�::achon es to ihe ;ecor..c�endction ¢ad .. <br />.YSrees fo instcl! a pre�cure re�ulating valve <br />s:y�ed � <br />Lic�:mec to instali ^-'s�.:su c:eaulating vo�ve <br />i ��J�� <br />Sir.nca �'� ''�f/_�_/—.-. <br />II is understuod llm� all connections, including meter and meter boc shall romain the propetq• o( <br />\lukiltco R'atcr Uistrict. q <br />E"� d o Y` � -pj"�� �- <br />Sianed _!�_����' , Owne: <br />� ,_,,, .. [�p �_ I� --� <br />... .. I' v ;� �JCixlddrecs I �'i � � � � <br />Pr1UKILTEO 1NA7EP I$N'sT— �c"`�•�'_Le_. �`'.� I S e,_ _��, Aacni <br />� i�ddress �'�. � 7 -`�� io I io ���yG /'�J �•"�% <br />TOTAL MATERIALS COST I 1� C�� I <br />FOR OFi�ICE USE ONLY: TOTAL <br />DATE COMPLETED � r-`'=i ___ ADD � <br />POST TO ACCT NO. �� i, =�sJ �%. ?� TOTAL <br />- � 7—� �-=�== CUSTC <br />----�--`-�=--�l. %�--- <br />