10715 20TH PL W 2016-01-01 MF Import

., :__:.-�, MUKILTEO WATER DISTRICT SNOHOMISH COUNTY WASHINGTO;� APPLICATION FOR WATER ^�Application No. � S/ �� b1 A�Y No. 7��"��o Meter Size �� Number of Units � Account No. U�D •/��/�� I hereby apply tor water service and agree to be governed in accordance with the re�olutions, rules 2nd regulations of ihe MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in effect. The undersigned as owner or representative of ihe herein•described premises hereby agrees as Tollows: ( 7) That the cost of any extension af the water servicq renewal, replacement or repair ro reach and serve the property descri6ad shall be bome by mysell or assigns as owner (s) ol ihe premises. (2) That all pipes, water measuring dovices and other connecting equipment upsiroam from the motershall, ahertheir installation, 6e and became the properry of the MUKILTEO WATER DISTRICT, subject to all its regulations pertaining to watar service. (3) That after installation, if ineter or metor 6ox and appurtencos aro buried or damaged, the ownor, wiil be held responsible and charged for same. (4) That Ihe MUKILTEO WATER DISTRICT, its officers and agents, shall have tho right of ingress and egress to go upon ihe prr.mises and praperty described herein br the purpose of inspection, conn�cting or disconnoctine� ihe sorvice or for such other purposes as the service may require. It is also understood during the timo that any of the water mains may be out ol service by reasopbf any emergency or improvements authorized by the DISTRiCT, in any s�reet or other locaiion in which they may have been laid, the DIBTRICT will not be required ro furnish water during the progross af such improvameNs to any consumer whose supply may thus be cu{ of(; br be liable for any damac�es for its tailure to do so. (5) That the DIS'iRICT shall havo tho right rochange the iates at an� time by Resolutinn,�to tomporarily discontinue the service ro consumers, and to install the mmer (s) to registor the water consumed. The DISTRICT shall not be h�ld liable far damage by wa�er orother cause rosulting irom dafective plumbing or appliances installed by ihe owner oroccupant on Ihe premises suppliod with water, and tho tact ihat agents ot the D I3TRICT may have inspocted ihe plum6ing and appliances shall not be plead as a bas�s (or recovory in case oF damage as aforesaid. If ihe supply of water shall fail or be intertupted by reason ol accident, low pressure or other cause whatsoevor, the DISTRICT shall not bo held liable tor damages nor shall such failure or iNerruplion lorany reasonable timo 6e held to constiwle a breach ol wntract on the part of the DISTRICT or in any way relieve the consumer, wheth�r ten�nt or owner, Imm performi ;; [he obliga!ion of such tenanPs or owner's contract. Water shall be used by applican[ only on the premises described herein. A new application shall be liled should water be desired lor other pmmises allhough located on land described herein. ir;n i�(6) That the DISTRICT recommends fnstalla�fon of a pressure regulating valve. Appllcam acknowledges Intormation as to Ihe �� recommendaqon antl assumes full responsl611ity for Installing or falling to Install a pressure regulaUng velue an the waler syslem to ` protect It (rom high pressurc. tNr ✓[��f�L(7) The DISTRICT util(zes check valves at the meter lo prevent wa�er re�urning to ihe Dlstric�s malns. The DISTRICT recommends �-�� inslallationolathermalexpanslontanktoproventezcesslveprassurebuiid•upcausedbythewaterhealer.Applicantsacknowiedges � Informetlon as fo the recommendation and nssumes full responslbiliy for Installing or falling to Install e Ihermal expansfon tank. �/SERVICE ADDRESS: �U �S/ -�//� 'y� n,� LOT NO. d _ BLOCK i � � {/ . PLAT NAME: ��_��_�J��✓ C�TY/STATE/ZIP: ��%ir�L.�,1 ,�L/%" . LEGAL DESCRIPTION: --- OVJNER'S NAFdE: �1L�L fv//I��L�SOy OWNER'S ADDRESS: /�1�•%� �� CITY/STATE/ZIP: � Y �l � � Thc premises are ro use as�TL� _ � e ' e , INFORMATION LETTER-GAV%jSENT: i��'1 iA CHARGES /7 ,4.� �� PAID �� (1) Service installation & wnnection charge 5 ��v • vV - (2) General Faciliti�s connection chargo S y�y �J FEB 1 91991 �3> o�n�� F /'I MUKILTEO WA?ER DISTRICi Total amount received with applicalion S ,�� IT IS UNDERSTOOD that this Application, although sic�ned, shall not bo binding upon tho MUKILTEO WATER DISTRICT until approved y the DISTRICT. � / I, Ihc undersignod, owner (or representative) of Ihe proporty describod above, do hore6y make application lor installation of a i � -inch diameter wamr sup/ply,service connedion, inclu ing appurtonances, and all necessary labor ut my expnnses. Dated Ihis � day�of �. ,/ i9 .�� , �i�— APPLICANT'S SIGNATURE: Applicanfs Name (please print): .vsri d �r�oy _ Applicanfs Address and Phone Number. � � �� APPROVED: ��' � � �'� 7!J � r3 -��d 7 MUK LTEO WATER DISTRICT %�� Da�. / � Y/ 0 G G U