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, �.:�i+� <br />,' .. <br />� <br />. ; r <br />� MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />�Application No. ��� ��p�b No. <br />Meter Size _ 3�/ ��� Number of Units � Account No. <br />I hereby apply tor water service and agree to be governed in accordance with the resolutions, <br />MUKILTEO WATER DISTRICT pertaining to water service, now or herea(ter in e(fect. Th <br />representative ot the herein-described premises hereby agrees as follows: <br />�!'/-�,L�' <br />o�a-��y� <br />rules and regulations of the <br />: unCersigned as ow�ier or <br />(1) 7hat the cost of any extension oF the water service, renewal, replacemer,t or repair to reach and serve the property described shall be borne <br />by myself or assigns as owner (c) ol ihe premises. <br />(2) That all pipes, water measuring dovices and other connecting equipment upsiream irom ihe meter shall, attor their installation, be and become <br />the property of the MUKILTEO WATeR DISTRICT, subjoct to all its regulations pottaininy to wator service. <br />(3) That afler ins:allation, il moter ormeter box and apputlences are huriod ordamaged, the owner, will be hold responsible and charged Por same. <br />(4) That the MUKILTEO WATER DISTRICT, its olficers and agants, shall have the right of ingress and egross to go upon tho promisr.s and propert/ <br />describad hmain lor the purpose of inspection, connecting or disconnecting th� service or for such uther purposes as the service may require. <br />�""��.__ ., ., „I(,Ls also understood during the time that any ot the water mains may be out of service by reason ot any emergency or improvements authorized <br />by the DISTRICT, in any street or ot�er locatior in which ihey may have been laid, �he DISTRICT will not be requirod to tumish water during <br />'� the progross ot such improvements to any consumar whose supply may thus be cut off, or be liable lor any damages for its failure to do so. <br />(5) That iho DISTRICT shall have the nght to changE� tho rales at any time by Fesolution, to temporarily discontinue the service to consumers, and <br />� toinstallthemeter(s) tnregisterthewatnrconswned. ThoDISTRICTshallnotbeholdliabletordamagobywatororoiherwuseresultinglrom <br />dofoctive plumbing or appliances installed by Ihe owner oroccupant on the premises suppliedwith water, and the fact thal agents of ihe DISTRI CT <br />may have inspocted the plumhing and appiiances shall nol be plead as a basis for rocoveq� in case of damage as atoresaid. !f �Iho supply ol <br />-' watershalllailorbcintermptedbyreasonafaccidenl,Iowpressureorothercausewhalsoover,theDISTRICTshailootbeheldliablefordamages <br />nor shall such toilure or interruption lorany roasonable timo be held to constiW�e a breach ot contract on ihe part ot Ihe DISTFICTor in any way <br />rolieve the wnsumer, whethur tenant or owner, from pedorming the ohligation of such tananfs or owner's contracL Water shall be used by <br />appiicant only on Ihe premises descri6ed horein. A new application shail be liled should water be desired for ether premises although located <br />,�( � on land described hercin. <br />n�r��J(�(6) Thal Ihe DISTRICT recommends installalfon ot e pressure regulaling valve. Applfcant acknowl�•dges Intormation as to ihe <br />�� recommendalton and assumes lull responsibility lor Installing or Ialling to Install a pressure regulating value on the water system to <br />protec� II from high pressure. <br />i�ur.�.j7)�The DISTHICT u�iflzes check valves at the mMer to prevent water returning to ihe Di.tdds matns. Thc DISTRICT recommends <br />- � �nslalla�ionofathermalexpansiontanktopreventezcessivep�essurebulld-upcausedbythewaterhealer.Applicantsacknowledges <br />`����^ inlormatlon aa to thc recommendetion end assumes lull respanslblliy for Inslalling or falling to Install a thermal ezpansion �ank. <br />� SEFtVICE ADDRESS: �//�� ��,�+� 9�� �OT NO. �O� BLOCK <br />PLAT NAME: � ti2l�'.� �� <br />CIIYYSTATE/ZIP: �� �Jv/¢' . LEGAL DESCRIPTIO� � <br />QWNEF'S NAME: ��/� /L�/9i TJL9S0� <br />OWWER'S ADDFESS: 1�� ,�9 �i,�z �� � <br />CITY/STATE2IP: ���,� �� y�'��v <br />Thc premises ara to bo used as a <br />�� _ <br />.� <br />INFORMATION LETTER-GAVE/SENT: � <br />CHARGES: <br />(1) Service installalion & connection ch�rge s �� D-� FEB 1 91991 <br />(2) General Facilities eonnaction charge <br />(3) Othcr <br />To4�l amoum received with applicauon <br />5 '� ' � UKILTEO WAiER DISiRICi <br />5 <br />g �d', . GT� <br />IT IS UNDERSTOOD ihat this Appliwtion, although si9ned, shall not bo 6inding upon tne MUKILTEO WATF�A 91STFICT until appmved by the DISTRICT. <br />I, the undersigned, owner (or represontative) ol the property described abovo, do hereby ma� � applica�ion lor inslallation of a_� �� -ideh <br />diameter water sup service connection indu ing appurtenances, and all necessary labor .:, my expenses. <br />Dated this _�_ day ofl ��g � <br />n <br />Af'�LICANT'S SIGNATUFE: <br />Applicanfs Namc ;plcase print): �a <br />�.� �ApplicanCs Address and Phone Numbr.r: <br />�� <br />APPROVED: �lZ��j� f"C_e � <br />MUKI� WATER DISTRICT .. <br />/�/ �L� <br />By /Q� <br />Date: <br />D <br />S7/' dGli Oi{/ <br />S'3���6% <br />