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<br />,� ._- ^,, • � � MUKILTEO WATER DISTRICT ���.3.�� r
<br />..' < SNOHQMISH COUNTY WASHINGTON
<br />APPLICATION FOR WATER
<br />^ �pplication No. �� �
<br />ho.
<br />•• v'- K,!(;•V'
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<br />IMeter Size Number ot Units _� Account No. 12�0— �75/(oKo�
<br />I hereby apply o weter service and agree t� ba governed in accordance with the resolutions, rules and regulations of the
<br />MUK!LTEO WATER pISTRiCT pertainir,g to water service, now or hereafter in eitect. The unoersigned as owner or
<br />representafiva o! ihe herein-described premisss hereby agrees as foilows:
<br />!11 That the r.ost of any ezteosion of the wator service, mnowal, replacement or repair to reach and serve the pmperty described �hall be bomo
<br />hy nty€�If ar �ssigos as oK��ier (s) of the premises.
<br />(2) That all oip�;s, water mezwr:�g devices and othar connecting r,quipment upstream irom :he meter shall, after their in,;�tiation, ba and bewme
<br />the prer��rty �I thc MUY,ILTEO WATER DISTRIGT, subjoct to ail its regulations p�rtaining to rrater sorvice.
<br />(3) That aftcr ins�allation, if mutor or meter box and appunenas are buried ordamaged, the own�r, will be hold responsiblo and chargod lor saTe.
<br />(4) Ttmt ihe tdUKILTFO WATER DISTRICT, its olf wrs and apoNs, shall have tho right of ingress and agress to go upon ihe premises and prope:t��
<br />describod herr,in for tho purpose of inspection, connocting or disconnecting tho sorviw or for such other purposes as tho service may requim.
<br />It is also urderstood during thotime ihatany ol the wate� mains may be out of service by roason of any emeryency orimprovements �uthorized
<br />by thc DISTRICT, in any strcet or other location in which they may hava boen laid, thc DISTRICT will not be requirod ro fumish water during
<br />the progross of such improvements to any consumor whose supply may thus be cut oH, or be !iahle tor any dama�es lor its faiture to do so.
<br />(5) Thnt tho DISTRICT shall have the right to chango the ratos at any time by Resolminn, to temporarily discnntinue the sorvice to consumers, and
<br />to install the memr (s) to register thc water consumed. Tho DISTRICT shall not bo held liahle for damage ����y water or other rause rusulting from
<br />defective plumbing or appliances installed 6y the ownor or ocwpant on the premises suppliod with water, and the fact that agents oF the DISTRICT
<br />may have inspeaed Ihe plumbing and appliances shall not be pload as a basis for mcovery in case of damago as aforesaid. If the supply ot
<br />water shall lail or be interrupted 6y reason ol accident, low prossure or other cause whatsoever, iho DISTRICT shall not he held 1ia610 for dama�es
<br />nor shall such tailure or intermption for any reasone6le timo bo held to constituto a hreach ol contract on ihe part ot �he OISTRICT or in any way
<br />rolieve Iho consumor, wh�thor tenant or ownor, irom porlorming the oblig�tion of such tenanPs or owner's eontract. Water shall be used hy
<br />applicanl only on the premisos described herein. A new application shali ba filed stiould water bo dosirod fo• other promises although localed
<br />; /on land described hcrein.
<br />v��5) That the DISTRICT recommends fnstallatlon of e pressure regulaling valve. Applfeant acknowledges Informallon as to Ihe
<br />recommendntion and essumes fuli responsibility for Installinp or lalling lo fnstall n pressure regulating value on ihe watar system to
<br />i� �T ���7) 1 ie DISITRICT ufl iesecheck valves et the meler to p�. :ent wa�er reWrning to the Districts ma(ns. The �ISTqICT recommends
<br />—� Inslalla�ionolalhermalexpansfontanktopreventezcesslvepressurebuilA•upceusedbylhewaterheater.Applicantsecknowledgos
<br />� I Information as to the recommendntion and essumes tull respons16111y lor Installing or falling lo Inciall a ihermel expenslon tank.
<br />S[RVICE ADDR[55: J�6.1i �4� CyL LOT N0. -�f'" / BLQCK
<br />/ 7 i / / � I
<br />PLAT NAME: ��[7������� � g
<br />i �
<br />CITY/STATE/ZIP: �^�� t� Tn� LEGAL DESCRIPTION: ��— �
<br />OWNER'S NAME; A./����y..=T�i,�rT�
<br />OWNER'S ADDRESS: �J �'. ���� � _
<br />CITYiSTATFJZIP: �,.���,LSi'�i�li/� ��/� ���r/ _
<br />O
<br />The premises are lo be used ac a S�. �
<br />INFORMATION LETTER-GAV'rJSENT: ��l��i�_
<br />CHARGES: \
<br />(t) Sorvice installation & connection charc�e 5_�% U(,L_L�
<br />(2) Genorel Facilitios wnnaction ehargo 5��� �(�J
<br />(3) Othcr § .
<br />SEP 101990
<br />MUKILiEO WAiER DISiRICI
<br />Total amoum received with appliwtion S_�/ �� �T/
<br />IT IS UNDcRSTOOD that this Appli;ation, although sioned, shall nol bo binding upon ihe MUKILTEO WqTEfl DISTRICT until approved by the DISTRICT.
<br />I, the under;ignod, owner (or representative) ol Ihe property descnbed ubove, do hereby mako appliw6on lorinslallation of a � mch
<br />diome�er water supply ;crvice r.onnection, including appurtenances, and all nocessary labor at my exponses.� T/,�
<br />Uated this � day o� �r��g �✓ % � �
<br />APPLICANT'S SIGNATURE: .�.:-L—f����'�j ..
<br />,����..-�
<br />Appli�anfs Name (please prinp: � � � � � ��
<br />� . i
<br />applicanPs Address and Phone Numbor: � � � �/�- � � �'�y. _ O d�� �—�
<br />�--r��;�� --�=-�',= t �,zy-.-=��-5, �
<br />APPROVED:
<br />MUKILTEO WATER DISTRICT
<br />gr-: //��1-•_.__�._
<br />Date: �/yG
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