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APP�CY-':'701d NO. <br />MUKlLTEO WATER DlSTRICT <br />-7 � AC,'70Ut7T ii0. � _i. i i� 1 C!. `. <br />- —_ — L <br />SNOHOMISH COUNTY. WASHINGTON <br />-,s <br />APPLICATtON FOR WQTER <br />l.:uLilteo.�9ashin9ton—.----- ' � °�'�'.19 ��' <br />TO THE SU?ERIt1T�I1DEt�T OF THE IdU{:ILTEO WhTE'r. DISTAICT: <br />? h=:ec;: appl)' lor the uce oi watc: m accordance v:ith Ihe :ules a�d :egula:ions ol <br />Inc tdu'r.ilteo Water District. . <br />During the time that any o't the water mains map be tcke� up by reesor. oi cny :r.i- <br />provemen; auti�or.aed bp t'ne Ds!nr, m o: o: any slreet, rcad o: alle•; �r. v:hic'r. ti��}• ma}' <br />nave beer, laid. tne '.'�:ctric: x•ill no! be :eqvi;ca to iurnish wcter dc:ing the prog:e;s o'. <br />cucn imp:o:enenl:. 7c cny co,-is�me: whosc suop!; ma� thun Le cW oi!, o: U^ liaF,ie io: <br />or.)• damagc Icr ifs laiiure 5C lo do. <br />The oa•ner sLall bc liable fot am� dama��cs to lhe servicc connection. <br />I <br />PItOI'BILTI' DESCI4IPTION: � � � � \ <br />noDa:ss:—_�''-� I �_ �_C'ri� �.�-� �_,.J <br />S!cic 51ze o( se:vi:e—.1_t.�_. incn �� <br />;_��uC <br />hcc bccr. re_civec with thia op,ji=�tio:: .� <br />_L"�-`�- �� � � ��.�7 � <br />i hc =rer:ises are to n^ usvd as c_� '�' "'��: U � -- <br />i iu� owr,e: d tne p;enises is _ r, 1Z ���' — -----" <br />'fhc co=nt is <br />Tiio Dictnct recor..men�=_ inct�llcuon oi c P:easure regulatiag valve. <br />J�.pph:an� acl:noxiedees mfo::�atior. os to tiie reco:nmcndahor. anG .. <br />L:-:ees to iastall c P:=�sure regula�in� valvc <br />Syncci _ l <br />Decli�estoinstall .e'eu�e:.agyla:�ny�elve - —_-- --- -- <br />Sia.^...,. /� —. — <br />li is understood that all cunnections, includinE meler and meter boa shall remain lhe properq� of <br />\Iukiltro \5'ater UistticL �� <br />� �"i i � ' $19n^[i J � /.%�� ---- . Owner <br />✓ n <br />hdd:esc `I � (�� ( l�-Gr1 �.1.� <br />. • � `� �.`l,', . ,� <br />Hp _ / --, h9ent <br />�-y__-.y��� <br />I+iU�iILTEO l'd°,T�6 DI�T. hddresc_— -- <br />-y � <br />TOTAL MATERIALS COST � I <br />FOR OFFICE USE ONLY�. <br />DP.I"E COAIPL'eTED _--_ --- <br />POS`.TOACCTIJO. _._'; I 1?�Ii =�_''����_- <br />---- (7y �u(f'i ._ <br />--- +—=—�" �� 1-- <br />