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/ r <br />APP�+IOF; t:p _ �`� _ ACCOUIdT NQ!/�'/r_ /..}L'"'✓_^-.�� <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUhTY, WASHINGTON r A2.� <br />— �1j <br />kPPLiCATiQN FOR WATER <br />�-�, ___ ,� ,_� <br />Muiilteo.Vfr.shiagbn—..""�._-. —��°=—J <br />TO iHE SU?E�ItCTENDE1dT OF THE MUF:IL?EO V�ATER DISTnI�?` <br />I ne;eby aP?�Y �os tne use o! wale: in accorder.ce �•+��1i tne rules and regul��io�s o! <br />the 6;ukilieo VJa�e: Uistri:t. <br />✓u:ing tne llne that any ol ihe water mair.s may ne tc'r.cr. up ny reasor. oi cny im- <br />provement author::ed by ine ?�i::tric: ir. o: o; cra� stree', ro�c or clley in wiich they mcy <br />h�ve �^en la:c, lhe District will no: be requi!ed to ium:�n •.votc during ihe prcg*ese o: <br />.,u_i. �mp:ovementc tc enp =�nsumer wnose supply me}• ���us �r cu: e!i, o: Se iiabie lor <br />c�y d�mayc 1or it� iailu:e sc to do. <br />'i'hc ou'ncr sLall be liablc for an}� damagcc �o thc scrvicc conncction. ' <br />^�i_ ? __- i � "'2c h.�-�' !��c7 <br />��korrari• t�t:sckirnon: '�- " = - <br />_' ,: :-�. /� �! �z: c.�,i �.-�. .x. <br />'? - <br />� �� c� y �� �.�, -� ,��. -s_ i i� <br />hDDRESS: � <br />�i� <br />�tal� sim o; s�rvice inch <br />y :7i� ��� . . . <br />.._ -.^.as been rece:vea wilh tnis applicatioc. <br />� /_c .°,c.l -c <br />'; he prcmise; are tc ne used as � � �J - - -�- ^ � � �� ���� �-� ' = ''= <br />p/ �,, , , <br />Thc. ov: �e: o: tne P'emses is �� I Uyhi`?'�i�� <br />�im caent <br />':i�e Dist:ic: reconr..ends i.^.�tallatior. o! c pres�ure :eguletine vaive. <br />•'+ppiicant ac}•n��wl�daer. inio:mation ac w tne remrr.:nendeuer. and ... <br />l.a:ees to in,t�Il a p:e�:�re reyulINing vClve <br />�e_iines te ir.st¢ll e p:ec::ure regulating vah'e <br />$•^�ed �� <br />It is unJerstoud that ali conneciions, including meter and meter box zhall remain Ihe propenl' of <br />pluAiltco N'alcr District. I (� ^ <br />r K 6� Si4ned^� �/ —�v' �.��LY.S-;-+\� � Gv:ne: <br />1 1q�Z hddres � L� 3 ti �. \JI `i�i_`_ -- <br />��ji���� 1 . ��+�T-�c C�G �CC _. ngent <br />MUKILTEO 1;'fJ_n DtST�' ? �,� _ 4G�� <br />p nodress ------- <br />i ^. -� � <br />TOTAL MATERIALS COST , - . <br />=pR OrFICc USE ONLY: <br />DATECCMPLETED —=-�--_-_-. <br />POST TO ACCT N0. _�r%�'�= �". c% <br />I�Y �).•�b <br />— < <_'.�__ —_ r_ � �� —__ <br />T <br />A <br />T <br />C <br />