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APPLICAT(O!i <br />/,_ <br />�� --- �_ ACCOUNT NO.�-^G-%S/iL�oGF <br />MUKlLTEO WATER DISTR[GT <br />SNOHOMISH COUNTY. WASHINGTON <br />APPLtCQT[ON FOR IMATER <br />�l <br />c--� <br />ldutiltec. VJ�;cin9���— - --. !° �'� <br />IJ �.AL SUPLRIIvTCNDLI:T OF TY.Y l.:U}:IL?EO 11'hT£P. DIST�ICT�. <br />i iie:e�� ap;.i; lo: tne use ct wa�e: ir: accord�nce •a•itn tne rulec and reaul�tions ot <br />tne M.u'r.ilteo Wme: DisL•i:l. <br />Du:ing tne tir.ie Cna: cny ol the wmer mains may ne tekea cF by reasor. oi en�� im- <br />provemen! autna.:zed by t�e L:^:ict ir. o: o! any ctree:, roac o: cllep in wnicF. Ihoy raay <br />have 6eer. la>;. tne ✓•st:iot v:ill ao: ue rtquired lo iu:nisS wcie: du:ing t6e F���:e__ o: <br />succ improvemertc Ie any co;,=umr. �shose suPPly �vay �nu; be. c,. o!i, o. oe !ie510 ior <br />any damagc for it� iaiiure sc Ic do. <br />The nwner shall bc liable Cor any' dama�es :u ehe service connection. - <br />` ;' - _—' <br />1'ROPERTl' UCSCItIt710N: "- . �=- � -• V - -- "•: t�,, ..� <br />�:• - J � <br />' .� � ^_ rC ,. � �__� f • ._. <br />l i� " i � ! %� �� /�!.i . � � ' <br />ADDRESS�. - _ - -- — <br />Stale .^,ize oi sercice �`� inci <br />�� I S�`. <br />$�__ hcs becn received wi(n Ynis apFlication <br />'."neP:emisesa:eto�eusocesa ��-„^e��'G.••�,�_ _ .�I_.c=_ c_ <br />?ne o�•net o; ine prer.�ises is _ �"I i �!�-:-y'-^'�x" ` - <br />'i ne coen: is <br />Tne Gisr.ict recom^ends :r.s:a'.iatior, o[ c F�essure :e�ulatin3 va!ve. <br />APPlieanl aai:np.� d�cs :nio:mation cs to t:ti.- ,ecor.ua^ndaucr. �nd ... <br />6gm^s �o install c P:�=sn:e rcaulatina •+alv� <br />S�ar.ed�' �}� :�,_ . `—__ '_-- -- — <br />Dec:ines to in^.tall a pressure reculating'�a::�_ <br />a�unc:a.. ____ _.__ <br />It is undervond tlwt all cnnncetiuns, indudine metr. and mete: bu� shall remain Ihe prnperry• nf <br />�IuCiltco \1'ater Uistrict. <br />t� fa i D 5,�,�� ��i.��`�2�e`� .���: ��: <br />hddress � � �-� �,, - , �-��� <br />'�UI�I 1 � 19a3 :. ,: �—i— <br />a,. - '�����i_:-. __ �- _ _ �,��:� <br />���h���T''� ,.....,. n�r:�d��_...._—�_ _ ` ._'_"__— <br />r..� � i <br />70TAL MATER� �A� L_� T�.� ..-, <br />FOF OP`rlCc USE UNLY: — f� <br />l" � '' --- <br />phTe COMPL"cTED — �� � �' — ���,� ��. <br />?0S7 TO AGCT NO. � �'.! " —__ — _ <br />i c.-� l_1_� � <br />l.b 7__ <br />