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� ��� <br />kn?Lich'riow n�o. — --- nccoutar iic "�SC C�Gf�F-- <br />MUKILTEO WATER DISTRICT <br />SNOHOMI>H GOUNTY. WASHINGTON <br />�� <br />APPLlCATlON POR WATER <br />� S,� <br />Mueilteo, �4ashington ��� , 19� <br />TU THE SU?ER!tdTE!JDEIlT OF THE tdUlilLTEO V'hTEA DISTRI�T: <br />1 hero5y apply io: Ine us^ oi w�ic: m accordance wilh fne rules and regulations of <br />tne ldukilteo Water Distric:. <br />During tne time that any o: the wctc: r.;ain� may be la4er. up b� reccor. o! a.^.� im- <br />provement authenzed i�p tne I'i:st:ict ir o: e! any streel, road o: alley in whicn tney may <br />iiave bee.^. Ivid, tne Lis�:ict v:ill not be required to iurnish wate: during lhe progrecs ol <br />sucn improvementa Ic eny consumer '+•'hose cuppiy :ne}' ihua ba [ut o1i, o: be i;a�lc (or <br />arty dama9c tor its laiiure sc to do. <br />Thc owncr shall bc liablc fo: anl' damagcs to thc sen�icc conncction. <br />I'ROPERTI' DBSCIt1I'1'ION:.. "� `� r j L <br />��t.-CA Y�t cti��1 l�c�4 n � I �� � <br />�,D���55: / c� �� o s � 9-�'- P e.. �,.' <br />� <br />Simc six o: scrvice inch <br />$�`� �-n nes be^_n receivec with Ynis aPPlicatioc. <br />n, � . � �_�__-_ <br />Thep:emsesaretobeu;edasc ,/ K'��C � �— �`�"-"-`� <br />4 a n � � <br />L'nc ow•ne: o: thc prc^iisca is /��C�4 :�+'. 1: - `n - ----- <br />The aocnl <br />Th� D strict recommends ir.ctalletior. o! a precsurc regulatir.q ve:ve. <br />Applicanl ac'v.no•a'Iecges mio::netio:i as to tne recommend�tion anc ... <br />Ac:c_r• to instail a pressure :eaulahng valve <br />�ia�ed_ <br />Declines to inslall <br />Slmco.�� <br />It is undcrstood that all conncctimis, m dinF meicr and mcic[ bos shaC �crosm thc property of <br />Atukiltco �1'atcr District. � <br />�� �'��: C`. 1..+%' r Si9�ed/ ./Ja �� —_____—_--. Owne: <br />�'��'' ) r, 1=1;.::: l,ddress _ 1 — <br />. .,: , . 9p.—_LL�.� ���c.h G �C 7a,� ��C.ICi h9^nt <br />I.�lUI�IL��G 1",'�.i-'r: [�I�T. �-- <br />� / <br />g l�dd:ess__3S ,� C�_S � —__— <br />TOTAL MATERIALS COST I�Y• � y <br />rOR OFFICc USE ONLY: <br />DATE COMPLETED .__ <br />POST TO ACCT IJO. __=' � � �4'� -� .� j '� <br />��� I � �� � <br />T07 <br />ADC <br />TOT <br />CUE <br />