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APPL .,a.TlOhi 1d0. _� __. <br />AC�OUNT PIO.u=fD`/SN Z �';iP/� <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH GOUNTY. WASHINC70N <br />APPLICATION FOR WATER � � <br />Mutilteo, VJcsningior. �'� — ��r , 19 0 � <br />':O TH� fiUP-P.IC'E1:DEN': OF T:iE b1U1:ILTEO V�hTEE D15TRIC?. <br />I heceby app17" io; tiie use oi wme: ia ac_ordance with tiie rulec and regulaticr.s o! <br />the MukiLeo `17ate: District. <br />Luring tne time that any o1 thc wate: ma�ns iray be to'r.c:: up by reason o! ar.y irn- <br />p:ovement autho:i:ed 'ny ��e Dis:.^.ct ir. o: o! an� str^�', road or alle� in which Ihey ma;: <br />nave be^.^. laid. thc Dist:ic; uill not 6e requve� to fu:nish mater du:ing the p:og:ess ol <br />sucn improvemeatc to any corsumer vrnese supply mv�� tiiue Lo cut o1!, or b� IicbL.� ior <br />any domage fo: i!c iailu; e so to do. <br />l'hc owncr shsll bc liablc for uny daniaEct to lhc scrvicc eonnection. <br />reo��eirrr <br />� <br />'/ � <br />l,DDFESS: I (`�J "7 � 'p — I 9��(.L� ��tt-t� —[_,/� � -- <br />S�rne s�ze o( sercice _ �� '�` inch <br />$, ��-S ' C�C� ha; 5eer. receiveo with fnis epplicetion. _ � <br />_ J j. � / � i <br />Tno premis^c are to be usec as c_�3�5.�—�� ,�-�-��-�""-�-'-C <br />/� ��� � J <br />r[1C Ot4':12: O: �flf P:CTlISC.`, 1.'. �u/�'Y =-'' �1.�✓l�/`....'S :'f _. <br />Thc age�t is <br />3 � � - �i s �7'/ <br />Th^ Dic:;:=; :c_oc�r.iendc incialla;�o� oi a p:e.�urc regulahna vcivc. <br />Applic�nt ac1:r.nv;iec�es info:ma;ior. as to fhe recommend¢:ion end ,.. <br />i�n;ces io inst�l! c pressu:c rogulating ealve <br />Sianc�d__ _ <br />Ded:n^e 10 install p crec�•�re tegulatino valve <br />S�anec - i r��n.. �-�._.� �n=�_ <br />/ <br />II is unJcrstuod Ih � all canncctions, including mctcr :md mctcr box shall remain thc p�operty of <br />\tukilico 1l'atcr Disvic;. � <br />i- �!. �. .!I i7 i <br />t�� .�-, .��-=�n�=�,-�_ <br />1 <br />IL�R�.P_'�='i; �, r <br />S�9ned _ . Ov�cr <br />��Q��)�ddrecs � �G �� G�'`-Fi ��1-4.��A:�CC� <br />v <br />': i.� '67'�_��t_..✓t.ai� � `Cr�G �/ _. Agent <br />'/ c.// <br />TOTAL MATERIALS COST I Y� �7 <br />FOF OFFICE USE ONLY: <br />DATE COAIPLETED _— _ <br />POST TO ACCT NO. ' " _' <br />/ i t'/ <br />v: <br />l-t-z .�� � t <br />