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�. . . .. . . . _ � : <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />_ . . ._. . .-q <br />� r <br />tJ' C <br />APPLICATION FOR N/ATER � t�j <br />3 �S � <br />�`�ApplicalionNo. /(�j No. ��� � <br />� <br />Meter Size _�/ �� Nu r o( Unils Account No. ��J� ��y�o7�S � <br />I hereby appiy for water service and agree to be governed in accordance with ihe resolutions, rules and regulations ot ihe � <br />IJ�UKILTEO WATER DISTRICT pertaining to water service, now or hereafter in effect. The undersigned as owner or U <br />representalive of the herein-described premises hereby agrees as toilows: <br />. (1) That the cost of any extension of tlie water service, renewal, replacement or repair to reach and serve the property described shall be bome <br />by myself or assiyns as owner (s) of the premises. <br />(2) 7hat all pipes, water measuring devices and other connecting equipmont upstream fmm the mcter shall, aftoriheir instaliation, be and become <br />�he properry of the MUKILTEO WATER DISTRICT, suhjoct to all its regulations penaining ro water service. <br />(3) That alter instailation, if ineter or metor boz and appunences are buriod or damaged, the cwner, will be held responsihle and charged tor same. <br />(4 ) 7hat Ihe MUY.I LTEO �VATER DISTRICT, its ofliwrs and agenis, shall havo lhe righ[ ot ingress and egress �o go upon tnc premises and pwperry <br />described herein far the purpose ol inspection, connoctiny or disconnecting the sorvice or tor such ather purposes as the service may require. <br />It is aiso understood during the time that any of the water mains may be out ot service by reason of any emergency or imprevemenls authorized <br />by the DISTRICT, in any street or olher location in which they may haw been laid, the DISTRIGT will not 6e roquired lo fumish water during <br />� the progress ot such improvements to any consumor whose supply may thus be cut off, or be liable for any damages �or i�s L�ilure to do so. <br />. (5) 7hat the DISTRICT shall have!he right ro change the rates at any time by Resolution, lo temporarily discontinue �he service to consumers, and <br />toinstalilhemeter(s) toregister�hewaterconsumed. TheDISTRICTshalinotbeholdliablefordamagebywaterorcihercauseresultingfrom <br />dc!ective plumhing or appliances installed by the owner oroccupant on the premises supplied with water, and the fact that agents of the D ISTRI CT <br />may have inspocted the plumbing and appliances shall not be plead as a 6asis for recovery in ease of damage as aforesaid. If the supply of <br />water shall fail or bc interrupted by reason of accident, low pressu�� or olher cause whatsocver, the G�STRICT shall nol be held liable br damages <br />nor shall such failure or interruptian lorany reasonable time be held to constitute a 6mach ot contract on the parto� the DISTRICTor in any way <br />mlieve the wnsumer, whether �enant or owner, fmm performing tho obligation ol s�ch tenant's or owner's contracL Water shall be used 6y <br />,� applicant only on the premises described herein. A new application shall be liled should water be desirod for other premises allhou9h located <br />��.p1� 1 on land descrihed hcrein. <br />nar _�� �e�' (6) Thal Ihe DISTRIC��. recommends InstallaUon ot e pressure reguleting vaWe. Appllcanl •ueknowledges Intormu�ion as to the <br />, ��- i recommendulion and assumes full responsibllity for Installing or �alling �o Install a pressure regulating value on thc water sys�em lo <br />ydl% protect It irom high pressure. <br />INT V �7) The DISTRICT utilizes check valves at the meter to preveN water reiurning to the Districis malns. The �ISTRICT recommends <br />— � installatianofathermalexpansiontnnk�oprevenlezcess;vepressurebuild-upcausedby�hewalenc�ater.Applican�sacknowledges <br />� � Inlorma�ion •. 'o �he recommendolion and assumes lull responsl6iily for Ins�alling or �alling to install a thermal expansion tank. <br />`� /']/ / // <br />SERVICE ADDRESS: � �� �'�.�� '"I� LOT NO. _� � / BLOC ' �b �' <br />/ � ,�-�/n ,/PLAT NAME: ! %!Y�l�'�L r"'��� f� • <br />CITY/STATE/ZIP� _si�/�. Uyl% /�� �Y'/�G Y LEGAL DES�C7Rq�PTIO��/� " �� �. " <br />OWIJER'� NAME: �I��C � rl � /_ L� N • // /-�l �,l�.l�yt-f�-`c— <br />OWNER'S ALDR'cSS: �� I ,�--rJ��` /�-f� • .�� � �'� ?�' <br />CITY/STAT'e21F: v�,.�.,yr�• G/f�036 _��(� <br />The premises are to 6e used as�, _ <br />^ � . �'��� � � INFORMATION LETTcR-GAVE/SeNT: � <br />CHARGES: <br />(1) Service installation 8 wnnection charge <br />(2) Gencral Facilitios conncctian ehargc <br />(3) Olher <br />Tatal amount received with appliwtion <br />/�jU . �-"✓ <br />5 �%,�v . !%�v <br />PAID <br />DEG 21 1993 <br />5 <br />5 /l(� p• G^ MUKILTEO WATER DISTRICi <br />IT IS LINDERSTOOD thal this Application, although signr.d, shall not be binding upon the MUKIUEO WATER DISTRICT until approve hy the DISTRICT. <br />I, �hc undcrsigned, owner (or representative) of �hc property desr,ribed above, do herehy make application lor insialiation ot a��� -inch <br />diamumr wa�er suy�ly serviu: connection, m luding appunen nces, and all necessary I�bor at my ezpenses. <br />Dated ihis �- / day of !��i���� .19 �_ . <br />�� `—��'..�-'.��-�— <br />,>� <br />