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r <br /> � � , <br /> � t . <br /> MNKIL7E0 WA7ER DI37AICT <br /> • SNOHOAAISH COUNTY WASHINGTON <br /> � APPLICA710N FOR WATER <br /> � ApplicatbnNo. �, ��0�� <br /> 4 � A000uM No. $ <br /> Meter Size Number of UnRs <br /> I hereby apply for water service and ay�ee to be govemed in axordance with ths resolutbns, rules and regulalbns of the <br /> MUKILTEO WATER DISTRICT pertaininp to water service, raw or hereafler h eHect. The undersiyned as owner or <br /> represernative ot the hereintiescr�bed premises hereby ayrees as folbws: <br /> (1) Thm tlre cast ot anY exmnaon d tlw wUor�ervin,renewal�repl�t a rp�ir b n�di rd sarve the propxry descnb�d�haA be borne <br /> by myaeH a euipns u wrtwr(+) of tl�s prvnias. <br /> (2j That aM pipes�waw mMwirMq dwlan�nd oUMr wnrr�ln9�P���V���Mom M nM�r shY.�fYr dw(r imt�llatlon�b�nd 6�mn» � � <br /> �ha pmpeny of tlr MUIOLTEO WA7ER DISTRICT,WbJat b d b�laion�pMLY1Yq b wYK�vka. � <br /> (3) That atter irofd�tlon�H meM a m�Mr bo:nd�pptrbnas r�buiW vd�np�d.lh�ownw�wi b�twld respondbla rd d�ary�d br a�. .� , <br /> (4) That IM MUqLTEO WAiER DISTRICT�Xe olFoars and�pwib.�tW irN M dphld Yq�r�nd��b po upon Qr pramias rd pap�ry � <br /> dewib�d Mren for tlw purpo�of Yup�aion.oannUin7 a dwa�raiq tlN��Ao�a br wah oYiw pupo�es u tlr servia maY nwN�• <br /> IticalsourdararooddlirinQlMlhrNdwtrryd�Mwa�srm�in�m�Yb�autdwrrfa�Mn��ona�YanwrYNwYaYnprovxn�nbata,ized �j <br /> by ths DISTRICT�in rry atrwt a aMr balbn in whioh!�y m�Y Irr�b�wi li4 M dS110CT wit net b�nqubd b lumi�h wM►duiinp � <br /> I�M pf001lp O}tid�MII�fOMR1�f11i1D�Ily OON1�IMf WhON N��Y fM1t h�cIR OR.0�0�I�hM 10f�Ily d���tOf Nt MN'�b do W. 1„ <br /> (5) ThM Ifa D137AICT thllrv�1M rtplit b dir�p�1M nW�l arry tin�by RMoM�bn�b 1�npa�ly dfaoanWma 1M wvic�ro oonwnws,aed � <br /> roirotallMmwr(�)brpfarrMwWroorounrdTMDISTRICTdWnotb�irWi�EUbrdwnip�bywwramhwoi�rauMirqkam U'� <br /> ddaetiwPlumbin0a�pplrwninaWMdhylMaw�waoavprRonMp�ni�wiPPbd�+M�wNx�rdlMhctMW�p�nboftlrDISTRICT p� <br /> „up h�v.fn.p.a.a tl,.pkimwnp.,d�pWnw�drll�ot n.q..d,..bri.�or noo�,ry b a..or an,,.o.o.a..aia n�A.wppy d O <br /> water�IW fel a W IM�rtupW M��W�M.bwPnw►�aolhwauMwlrborw.M DISTFiICTtluM nd b�IrN A�6Nfadomp�s <br /> nor�Ilwchl�ilureaUMarrupionformYro�a�bMem�b�Mldbaorulf�abn�chdmMraetmtlrprtMYrDI3TRICTainrql�Y Q <br /> nYew dr aonwrtwr�wh�Mrr Wwrt ar awner�kom pwbrtnirq rr abip�Ym ot wrh YrWRs aawiwls aontri WWr tlwM b�uwd by <br /> ��PP��Y��P�dMabd Mrain. A mw�ppliaYan�!W b�lid YwiAd rials b�dnitid far odw praniMs atlw�qh bcard <br /> on land dnab�d haoin. <br /> M ThN tlr �ISTFIICT noeeMnwd� ImpYlbn of � pnasw ►pti�Wlp'l�Nra Appie�nl �d�nowNdp�� Iniormtllon p b IM <br /> ncomm�nd�tlon ud uwm�a WII mponsiblqry lor ImqIMeY a h�Miq b YrWI�pn�w�npuNtlnO valw an tlr MMK sys�wn w <br /> ptoaot k Irom Nph pns�u►w <br /> nrt (� Th�DISTRICT uG11sN dNek wivM.t tM mwr a pnwm w�w nM�nYq a b Dbtrbu�uim. Th�D1sTRICT mm�n� <br /> InwM.�an d■tlwie�l aP�wdca prw.nt���iv.Pn�wr�bulld�p onwd M fMrnrr Iw�w.App�o�nMa�bawMdYM <br /> MIOfln�O11 p�b IM^IW W�IIM �tl011/�}I�ld�MIMOM fW�MP011�1�f0�Nlt M/�b 4Mti�tllQlll�l tltpNMla111��1k. <br /> �0 WYIy <br /> SERVICE ADDRESS: 11lC I,�[ �� /�J� �.C� I.mNO. I BLOCK _ . <br /> PU1T NAME: <br /> CIT'/STATFJLP: � �����' �� <br /> ♦ <br /> OYVNER'S NAME: <br /> � <br /> OWNERS ADDRESS: q � —� <br /> CITYSTATE2IP: � 0 <br /> � " 1 <br /> The premisas ar�b be used as• <br /> INFORMIITION LETTER�GAVFJSENT: <br /> .�„` CHARGES: � pnaL <br /> �,�s«��.d�.���,�,�,�o. : � U JUN 2 31999 <br /> �z1 conx.�F.aww.oonnaeuon eh.rw f MUI(��TEO �SiR <br /> �3�°�," ' 10 .� wAiER p � <br /> reml.man�v.o.iuea wid�appYc.ua, s <br /> IT IS UNDERS700D Ihat Ihis Appliaum,�tlwuyh dqned.sh�1 na be binan0 upon the MUKILTEO WATER DISTRICT unul�ppo �/y/yfp�''DIS�i�A�IC7. <br /> t,the undersigned.uwner(u rePreeeMauva of IM property dsaaibed�bove�do AN�bY m�W�ppiration lor inaWl�tlon d e _�e/ inch <br /> diameter wawr�-up�y �tjp4ce co �i W � �u^4'��M^�• <br /> ti.r, Dated Ihis i7�J -- of �1 <br /> „�, APPUCANTSSIGNATURE: <br /> AppiicanCs Name(Weaae prinq: � <br /> s�- <br /> ApplicanCs AdBess and Phone Number: <br /> APPROVED: � � � �/�� <br /> MUKILTEO R DISTRICT <br /> �: L t!/�'J <br /> By: <br />� , <br />