11104 17TH CT W 2016-01-01 MF Import

i-�"-:''�.c'«eC-;Yl',. •_'. ►r.: 'r'�l�''., '.�''�'�'.,��''''�"t`:3'.�.,WS�*�'.�'�!.'"fi.e.^,7!�!�+e",.'�y,".�5. -�j,,�:��. MUKILTEO WATER DISTRICT SNOHOMISH COUNTY WASHINGTON APPLICATION FOR WATER Application No. 9 No. ��6 Meter Size �/ Number of Units �l AccouM No. ��b �JG 7%Z D I hereby apply tor water service and agree to be governed in accordance with the resolutions, rules and regulations ot the MUKILTEO WATER DISTRICT peRaining to water service, now or hereaiter in eNect. The undersigned as owner or representative of the herein-described premises hereby agrees as follows: (1) That the cost of any exlension of the water service, renowal, replacement or repair to reach anJ servr� the property describad shall be bome by mysell or assigns as owner (:) of tha promises. f:) That all pipes, water measuring davices and other conneeEng equipnent upstream trom the metor shall, aNer their insWllation, be and bewme the properry of the MUKILTEO WATER D�STRICT, subjea to all its regulafions pertaining to water service. (3) That afler installaGon, if inelar or meter twx a�d appurtences are buried or damaged, the owner, will ba hold responsible and charged for same. (4) That the MUKILTEO WATER DISTRICT, its oKcers and agents, shall have the right af ingress and egress to go upon the premises �nd properry described herein tor the purpose ol inspectlon, canneaing or dswnrroc6ng the service or (a such ather purposes as the service may require. It is also understood during the fime that any ol the water mains may be out ol service by reason ot any emargency or improvements authorized hy the DISTRICT, in any street or cther lowuan in which they may have heer. laid, ihe DISTRICT �vill not be rvquired to fumish water during . the progress of such improvemenu to any consumer whose sup�ly may thus ba cut otl, a be liabla tar any damages for its faiiuro lo do so. (5) That the DISTF.ICT shall have the right to change the r�tas at any time by Resulution, to tAmporarily disconGnuo the servico to censumers, and to insrali the meter (s) to regicter the water consumed. The DISTRICT shall not be held liable for damaga try water or other cause resulting Irom � defec6veplumbingorappliancesinstelledbytheowneroroccupantonthepremisessuppliedwithwaror,andthofaqthatagontsoftheDISTRICT may have inspectad the plumbing and eppliances shall not be piead as a trasis for recovery in case of damago as aforesaid. If the suppiv ol weter shal� lail or be interrupted by reason of accident, low pressure or other wuw whatsoever, the DISTRICT snell not be he�d liable tor damages nor shall sur.h faiiuro or interruption for any reasonatio fime be held to cons5tute a breach ot contract on the part of the DISTRICT or in any way rel?eve the consumar, whether tenant or avner, hom performi� the o6ligaEon ol sueh tenanCs or owner's contract. Water shall be used by applicant only on tho premisas desuihed herein. A new applicafion shall be filed should water be desired for other premises allhougn located. on �and dcasaibed herein. L� �� iNr S� (6) Thet the pISTRICT raeommends Installe�lan o( a pressura reguleting velve. Appllunt aeknowledgas lnlormetlan as to Ihe f recommendatlon and assumes tull responaf4111ty lor i�tallinp or felling to Ins�ell e prr surs regWating velue on ihe weler syslam to �� pro�ect II from high presaure. �' `" '' mT _(� Tha DISTRICT utilizes check valves at the meter ta prevent water rewrning q ths Db�dets malns. The�DISTRICT recommends fnslallalion ot a iharmal expenslon lank to prevunl a;celalva preasure bulid•up caused by the waler heater. Appllcanls acknowledgas inlcrmetion as to �ha reeommendeUon and assumds'fulf reaponsibllty for Instailing or lalling to Install a thermal expension tar.k. SERVICE ADDFESS: I��U� �7� �� _ LOT NO. � BLOCK C�N/S'fATE21P: ✓�T9�i�/W�� , YG�I . '�D � O,L—, OWNER'S NAME: �� / OWNER'S ADDRES�S: /i 4��% �3ti !.�'i"� /� CITY/STATE�ZIP: �" a� i"�Q' 93'i 9�% PLAT NAME: �� LEGAL DESCRIPTION: - �� The premises are to be used as a � �� 6 INFORMATION LETTER-GAVE/SENT: CHARGES: (1) Service install�uon 3 wnnection charge S /�� G� JUN � 3 �gg� (2) Generai Fadlities connection charge g �/� /. G� �a� omer g MUKILTEO WATER DISTRICT 7otal amount received wi�h appliqtion g � 3�� G� IT iS UNDERSTOOD that this Applica�ion, althcugh signg�, shall not ba binding upon lhe MUKILTEO WATER DISTRICT until approve y the DISTRICT. / I, the undersigned, owner (or representa6va) of the propeny described�above, do hereby make applica6on lor installa6on of a �� -inch diameter wa�er supply servim wnnecGan ncluding a purtenances, and all nete sary.J9bor at my expenses. Dated this /? � day of _: .' �I . � T_.,j�B �i —' APPLICANTS SIGNATURE: x � Applican; s Name (please print�: �� L n� �( y v� App!icanPs Address and Phonr. Number. �r' ?� � �� '�c �� APPROVED: �'u %�'nP`� '1!/�' 9 F J q' i-� MUKILT AT R UISTRICT By: � � Date: �y�_