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' MUKILTEO WATER DISTRI;T
<br /> - SNOHOMISH COUNTY WASHIN3TON
<br /> APPLICATION FOR WATER
<br /> � 1 �jS" ,-. � ,i ;=�
<br /> Appiication No. ✓ I D J��� -�' "J _ �
<br /> � No.
<br /> Meter Size `� Number of Uniis I Account �do. U�U " ��� ��JJ
<br /> I hereby apply for water service and ao•ee to be governed in accordance with ihe resolutions, rules and regulations of ihe p
<br /> MUKILTEO WATER DISTRICT pertaining to waler service, naw or hereaffei �n eifect. The undersigned as owner or �
<br /> representative of the h,;rein-described premises hereby agrees es(ollows:
<br /> (7) That�he cost of any oziension al the water sorvice,renewal, replacement or repjir to rcach�nd serve the properry described shall be bome
<br /> 6y myself or assigns as owner(s) ot the premises.
<br /> (2) That all pipos,tvater measuring dovices and otherconnecL��,,�:quipmont upstraam fmm lhe motor shall,aRor their installacion,bo and become
<br /> the properry of the MUKILTEO VJAT'cR DISTRI:��i, suhiect m all its regulatior,s pertaining to water service.
<br /> (3) That alter installation,if ineterormoter hox and appurt�ncos are 6uried or damageo,tho owner,will be held responsible and chargod for same.
<br /> (4) Thatthe�dllKILTEOWATERDISTRICT,itsol6cersandagon�s,shallhavethorignlofinGmssandegresstogcuponthepremisosandproperty
<br /> described herein tor tho purpuse ol inspec:ion,connocting or diuonnecfing thu service or for such other purposes as tho service�+�v require.
<br /> It is also understood during tho time that anv of tho wator mains may be out of service by reason of any emergency or improvements aulii:rizvd
<br /> by the DISTRICT,in any suoet or other lowrm in which they may have boen laid,tho DISTRICT will not be required to furnish water du�ing
<br /> tho progross of such impmvements to any consumer whose supply moy thus be wt ofl,or be liable for any damages for its failuro to do;�o.
<br /> (5) That tne DISTRICT shall have tho right to chango tho ratos at any time hy Rosolution,to tomporarily discominuo the sorvico to consumers,and
<br /> ro instaV the meir.r(s) to register the water consumod. Tho DISTRICT shall not be he!d liablo inr dama90 by wator or other cause resuiting irom
<br /> dofeclive plumbina or appliance,installed by the ownor oroccupant on lhe premisos suppliod with water,and�ho tact that agonts ot the D ISTRI CT
<br /> may have inspected ihu plum6ing and appliancos shall not bo plead as a basis for rocovory in case of damage as aforesaid. If the s�ipply of
<br /> wat�r shall lail or be iNertupted 6y reason ol accident,low prossure or olher cause whatsoevor,the DISTRICT shall not be held liable for damages
<br /> nor shail such faiWre or interruption lor any roasona6le tima he held to consliWto a breach ot contract on ihe part of the DISTRICT or in any way
<br /> reliove tho consumor,whethor tenant or ownor, Irom podarming the obligation of such lenanPs or owner's conVacL Water shall bo usod by
<br /> aFplicant only on the promises describod horein. A now applicatirn shall be filed should water bo dosired lor oher promisos although locatod
<br /> on land describod heroin.
<br /> iN �� � (6) Tfiet the DISTHICT reconmends Installation ol e pressure reguleting valve. Applicant acknowledges In(ormation as to the
<br /> � recommendatlon and ussumes lull responslblllty lor Instnlling or(elling lo Instail a pressure regulaling value on ihe weler system to
<br /> � pro�ecl It from high pr ssurc.
<br /> ir� � �="(7)�The DISTRICT ulll!_ . chock velves n� �he meler �o prevenl water re�urning to the Dislricts melns. The DISTRICT recommends
<br /> %- Inslelletlonotathern�dlexpenslonlenktopreventexcesslvepressurebulld-upcnusedbythewatorhenler. Appllcantser.4nawlndges
<br /> ��.� Informution as to �he recommeqdn�fon and essumes lull tespons16111y tor Install�qg or falling to Instoll e Ihermal expanslon tank.
<br /> '�- ) ��. � J, I
<br /> SERVICE ADDRESS: �L" ��"� I J� �V•r � LOT NO. ^"� B�.00K �,�_
<br /> I I PLATNAME: �`�-�.,..I' IL.�'�(.) �-i I ��������� +�..r 7",�
<br /> GTYlSTATE/ZIP: ����'� ._�� � �1J r� �� � "7,��� ��
<br /> � �- LEGAL DESCRIPTiOtI:
<br /> OWNER'S NAME: � Y�� C �' �LS A t 1
<br /> OWNER'S ADDRESS:� � S U � � 1 V• �.I�f s �
<br /> CITY/STATE2IP: L ✓� �r !/ w�, __9 b'a���
<br /> � ,
<br /> Thc premisos aro to bo used as a �!�� (--��-� r ��� �`^� �� � � �_
<br /> J , � ,
<br /> — INFORMATION LETiER-GAVE/SENT: --I�r�✓,I�,�'f�
<br /> � ' `� '.-'� '�� �� CHARGES:
<br /> „/f� �,
<br /> . �' (1)Servica.installation&mnneclion charge 5 /'' ` • MAY 3 0 pp00
<br /> ' � '- (2)Genoral Fadlitios�eonnoclion chargo $ 1���•����
<br /> �3�otner S _ MUKILTEO WATER DISTRICT
<br /> _ �' i
<br /> Total amount roceived with applipGon S - �''�-' '�
<br /> iT IS UNDERSTOOD that this Appliation,although signed,shall not bo binding upon the MUKILTEO WATEF DISTRICTuntil approvod b7!Itt7e qISTRiCT.
<br /> I,the undersignod,ow �(or ropresantativn)ol tho propeny doscribed obovo,do hereby make application for installaGon of a 1� l� mct
<br /> diamoter watersy,5pty�ervico connoction,ircl��ng aPpuhenances, aad all nerassnr�Iebor at my oxpensas. �
<br /> Dated this ��..' da;of.- �� n � � -�!� / �/ � - ; '-�,i(�f .
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<br /> APPLICANTS SIGNATURE:��� u��"`�"/ ��
<br /> /1� IC ,CU
<br /> ApplicanYs Name (ptoase prinq: ��'�7 W �''' J I � � �/`� � ,'I
<br /> � ApplicanCs Address and Phono Num6oc IV SU I f� W e s / 7� �kCU �" . ,
<br /> APPROVED: �� 3 3 - U 7 3 � f��„ /?c U���`4
<br /> MUKILT. Wl�TER DISTRICT �5��faC� 11�•�'.�U� �
<br /> �,� � � 1.��o�� �c'si //^ ,c
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<br /> T " � :���"`
<br /> ey: % i, i Date: � ,?7^7?" .
<br /> �% 7� �t�:°.. '
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