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"" '. . � .. . . ... . '" ' .._2 ^ .�Y., .. .+m...•: 'Y""-" <br /> ..� .. . . .. . .. _ . , .�. .:e . <br /> � / <br /> MUKIL7E0 WATER DIS7iUCT <br /> SNOHOMSH COUNT1f WASHINGTON <br /> • APPUCA710N FOR WATER I[I� 0�0.3 c��7[�O <br /> Applicatfon No. � <br /> �� No. <br /> Meter Size Number af Utdts I Acoount No. ��' 03.�0� <br /> I hereby apply for water servka and agree to be povert�ed In axordance wilh the resolutfons, rules and regulatbns of the <br /> MUKILTEO WATER DISTRICT pertainirg to water service, now or herea(ter in attect. The undersfgned as owner or <br /> represemative of the herein-descn'bed premises hereby aprees as foliows: <br /> (1) That�ha cost of arry�aenaian or the wamr prvice.rmewd.npl�o�rtient a rprr b raoeh ard rarve th�prapery dsaeribed eh�M be bome <br /> by myteN a auignMs owner(t) of Ma pramiMs. 1 <br /> (2) That atl piPw�wa0er rt�wrirq dMan�nd alh�oomretlrq pWpmwK WsUwn liom M m�Ma1W�Wa tlwk irutaNatim�M and Mcoma <br /> the properry of tlw MUItlLTEO WATER DISTRICT,subj�ct b d ib npWebnt p�rdYiYp b w�Mr�wvia. <br /> (3) �hat drer instal4fion�H meEs a ma�ar box and�ppuMnas�n Maid ad�mepW,tlr owmr.wi b�hNd rwponsbla nd dwp�d fa wne. <br /> (4) That IM MUKILTEO WATER DISTAICT,rts o1Rwr rd ap�nb,ahN Irw IM ripht d inpiw rd prsu b po upon tlw p�mbes and pro{prty <br /> decai6ed hxein ior tIM purpose of hepecUai�aanndiq w d�oarNClYq th�wrNa v lar tud�olha pirpo�es�s tlia�ervioa may re. <br /> a <br /> It ia also urderslood dump IM ume Ihtl�ry d M w�M m�Yu m�y b�wt d arMo�by n�wn of rry erMrp�rwy a Ynprowmanb�zed <br /> by�he DISTRICT,in arry strs�t or otlw bc�Yon in whkh tMy mry h�v�W wi Wd,M DIS7AICT wN not b�nquYW b lumsh wqtx durirp <br /> tha proprets of such impoNmanit b any pnsum�r whow supply mq Yar b�eut oM,a b�frbN br ny drnap�s}or ib aM(luuro ro do w. <br /> (5) That fhe DISTR�CT shaA hav�tM rfpM b dinp�M n�s n�ny ti�w by RaoArtlon,eo amPorariy dboon�m,.a,.a�vta ro oo„wn�rs a„d <br /> minstaptl�eme�ar(:) WrepislwlMw�woauunrd. il»oISTRIcrdWnotb�IWdiebbbrd�rtup�bywderwotlwaw�mulUrqhom <br /> defeetive plumbYp a appGnon ins W Nd by tlr anNr a oavpra on tM pnmiw�wppied wNh vn�er.and tlw lau tlwt p�n b of Mr D ISTRI CT <br /> may heve inap�ctid ths pNim6irq and appBur.as sAtl rat b�pM�d n�bnb br nwwry in we of dem�p�u alaa�aid. H the wpply of <br /> waterahel lail ahe in0emipd byrsuon of�oddxM,bwp�uur�aolhaesua whmwr�r,Or DISTpICT YWI not W hNd R�bia lademepes <br /> na ahatl sueh failure a iiMxrupbn lor�ny reesonabla tlm�b�Mld b aomtlarta�br�h d mntrst an Ihe part of IM DISTRICT u in erry wsy <br /> raliew tlh oonwmar,wlMlher tanant a ow�er,kom pxlormiq tr abip�tla�ol wdi 1Mwds a owiwls oontrect. Wtler d�dl pu wed py <br /> app6eant oNy on Mr premne�dewibW Mnin. A nsw epplic�6on�trl b�filed�IauW waeer 6�dnired fa oMer praNws�Mbuph loaled <br /> on lard duai6ed harein. <br /> ��r (6) Th�1 tlr DISTNICT naommw�d� IniWl�Uon ol � pnuun np�d�tlnp v�Na �prrm .au,owaao.s �nto�m.non .. a a�. <br /> - roeomm�nd�ilon�nd pwmn lull rNpondbUity for ImW Wq or ld/np ro Nu W I a prNwn npWatlnp vYw on M�w�ur sy�qm b <br /> prouct It hom hiph pnNun. <br /> wr (� ih�dSTRICT uUllxa ab�ck wiv�s at tIM mNN b pnwnt w�Mr�WmMp lo tM Obtrkb mdna Th�DISTRICT naomm�nds <br /> ' In�uWlbnolatlrrmH�p�mlontankWprw�nteaoMdwpnawnbu�k�upww�dbylMw�NrhpMr.Apppa�nY�eM�wMA�dpM <br /> Infam�Uon�O� � 7"1,K.auumw N�rr�Ory br Imt�np w I�MnO b Imtdl�th�rmY�ndon 4N�. <br /> �. 1 /J. <br /> SERVICE ADDRESS: W ��� pLpCK <br /> PLAT NAME: �r <br /> CITYBTATFJZIP• LEOAL UESCRIPTION: _ <br /> OWNER5 NAME: 'P• � C�Y �jP, T . __. <br /> OWNERS AODaESS: s, — v � ' � �� _ <br /> CITYISTATE'ZIP: � t� iLT'�v �� Z� ' (�j'f <br /> Tha premises are ro be used as a �� `,�qp� <br /> — {NFORMATION LETTER-GAVE/SENT: � <br /> CHARGES: "�o' PAID <br /> �»s�n.rrru�a��a��. s M�1Y 0 5 19� <br /> (s)cerwral F.die.s can�.ceon clw0. s <br /> �3�°'ne' s �q.� MUKILTEO WATER DISTRIQI <br /> retd en,«nt reaiwa wiln.ppYnrnn s I IGI..i�� <br /> IT IS UNDEFiST00D Ihat tliis Appfi�auon,dtlwuph siqrd,�hal nq b�bHdnp upan tlw MUYJlTEO WATER DISTRICT und apqn��the DISTRICT. <br /> I.the undareipxd (or represen ol �jryrty ds�aibed M�by mNr appiabn lor in�WM�w�d a _ inch <br /> diametar weter, comec' appurten�nas, ��lebor at rtry expentes. <br /> Dated this _��day d �!0 <br /> APPLICANTS SIGNATURE: �� <br /> �aa�,r.ri,m.c�,�..�n: D Y� �.� rs'' y/ �/y1p) <br /> ApplicanCs Ad6ass and Pfwre Number: �S s� �� , � /� 1 L�c� �ZS)7`-73 'i"—`� �'�I <br /> APPROVED• ' <br /> MUKIL TER DISTRICT ,�1. �' `• II <br /> � . ✓ .f ,.•,� � <br /> ey: � � ou.: 3 � F � �I <br /> __ _ _ I <br />