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"� <br />..-i• _-� <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHING'fON <br />APPLICATION FOR WA'.ER <br />^�Ap�licationNo. �_ �{/Q'O}—01'% No. <br />Meter Size ��� Number of Units � Account No. <br />I hereby apply for water service and agree lo be governed in accordance with ihe resolutions, <br />MUKILTEO WATER DISTRICT peAaining to water service, now or hereaiter in effect. Th <br />representative of the herein-described premises hereby agrees as follows: <br />�-� <br />Do76 -/7`�74�zo <br />rules and regulations of the <br />� undersigned as owner or <br />(1) That the cost of any extension ol the water scrvice, renewal, replacement or repair to reach and serve the properry described shall be 6orno <br />by myself or assiyns as ownnr (s) ot ihe premises. <br />(2; That all pipes, water measuring devices and other connocting oquipmont upsheam from the motorshall, ahor theirinstallation, be and become <br />the property ol the �dUKILTEO WATER DISTRICT, subject to all its regulations pertaining to water service. <br />(3) That after installation, if ineter or meter b❑ z and appurtences am huried or damaped, th2 owner, will be held responsible and charged for same. <br />(4) Tha! thc MUKILTE05'JATER DISTRICT, its ofticers and agonts, shall hove iho ri�ht o: in�ress and egress to go upon tnc premises and praperty <br />described herein for Ihe purpose ol inspection, connocting or disconnecting Ihe :�ercice or for such other purposes as the service may require. <br />It is also understood during tho time that any ol the wator mains may be out of service by reason ot any emergency or improvements au�horized <br />by the DISTRICT, in any street or other location in which Ihey may bavo been laid, tho DISTRICT will not be required to furnish water during <br />tne progress of such improvements to any consumor whose supply may thus be wt off, or be Iiable for any damages For its faiWre lo do so. <br />(5) That the DISTRIGT shall have tho right to chango iho ratos at any time by Resolution, lo temporarily discontinue ihe service !o consumers, and <br />toinstalllhometer(s) toregistcrthewaterconsumed. TheDISTRICTshallnotbchcldliablafordamagebywaterorothercauseresWtingfrom <br />defective plumhing or appliances installed by the owner or occupan[ on Ihe premises suppli�d with water, and Iho fact that agenis ol !he DISTRI CT <br />may have inspected the plum6ing and appliances shall not be pload as a 6asis lor recovory in case ol damage as aforesaid. If thc supply of <br />watershallfailorbeintermpledbyreasonofaccid'ent ;'?ipr�ssureorothercausewhatsoever,�heDISTPoCTshallnot6eheldliablefordamages <br />nor shatl such tailure or imerruption for any roasonab�e time 6e held to wnslitule a breach ol contract on the part ot tho DISTRICT or in any way <br />mlieve ihe wnsumer, whether tonant or ownor, irom perlormino the o6ligation ol such tenanCs or owncr's convact. Water shall be used 6y <br />applicant only on tho premises describod hemin. A new applicalion shall be filod should wator be desired for other premises althounh located <br />on land described herein. <br />iN; ��;6) Thal the DISTRICT recommends Installation of a pressure regulaling valve. Applicant acknowledges Intormatlon as to the <br />recommendet�on and essumes full responsibllily for fnstalling or tall(ng to Instail a pressure regulaling vaiue on the waler system to <br />prolect It Irom high pressure. <br />ircr (7) The �ISTRICi ulllizes check valves et the me�er ta prevent water relarning to �he Dislricis malns. The DISTRICT recommends <br />��'� installutlonolathermalexpanslontanktopreventezcessivepressure6ulld•upwusedbythewaterheater.Applicnnlsacknowledges <br />.�� Inlormolion ns lo Ihe recommende�lon and assumes lull responslbilty tor Installing or talling to Install u Ihermal expanslon tank. <br />SERVICE ADDRESS: �D,Z� =�l �/i�C �� LOT NO. BLOCK ` � <br />� / '� ��,� PLAT NAME: ��L/�/ <br />CITY/STATE/ZIP: '��"� _ �J_�A'. • — _ LEGAL DESCRIPTION: _. . � <br />OWNER'S NAME: <br />OWNEF'S ADDR[SS: <br />CITY/STATE/ZIP: <br />The prernises are to 6o used as a _ �' <br />.� INFORMATION LETTER-GAVE/SENT: � �� <br />CHARGES: ,) AID <br />(1) Servica installation & connection charge S /��7 �• � v <br />(2)GeneralFacilitiesconnactionchargo S `y3�• DU FEB 1 9199i <br />�3� om�� 5 /� LTED WATER DISTRICI <br />Total amaunt received with appiication S �U �%• �� <br />IT IS UNDcRSTO�D that �his Application, atlhough si�ned, shall not be binding upon Ihe MUKILTEO WATER DISTRICT until approvod by the DISTRICT. <br />I, Ihe undersi�ned, owner (or represontative) of Ihe property described obove, do herehy make applicatid�{ lor instailation of a 3 l �� -ipth <br />diameter wa�or supply�ervice connection � cludmg appurtenances, and all necessary labor at my expenses. <br />Dated this _�(/ day.cl�� ` � - �/ 19 <br />U� . �/��---"l_ � . <br />APPLICANT'S SIGNATURE: <br />ApplicanCs Name (plcasc prinq:� �� <br />�— API <br />�'f'. <br />Ml <br />� <br />("i'/✓� r/ d c 7/O/5� <br />� <br />� <br />� <br />$l.) <br />d <br />� <br />� <br />': <br />v <br />� <br />� <br />c <br />