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� y) <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />Application No. � No. ���!"�� <br />Meter Size ���� Number of Units � AcCount No. 0� �— � 7G77 y� <br />I hereby apply for water service and agree to be govemed in accordance with the resolutions, rules and regulations ot the <br />DAUKILTEO WATER DISTRICT peRaining to water service, now or hereafter in effect. The undersigned as owner or <br />representative oi the herein•described premises hereby agrees as follows: <br />(1) That the cost of any extension of the water servi�:e, renewal, replacement or repair to reach and servo Ihe properry descri6ad shall be borne <br />by mysell or assigns as owner (s) of the premiwe. <br />(2) That all pipes, water measuring devices and o[herconnecling equipment upstream irom the moter shall, after their insulladon, be and bemme <br />the property of the MUKILTEO WATER DISTRICT, subject to all its regula6ons pertaining to water sarvice. <br />(3) That atter installation, if ineter or meter boz and appunences are buried or damaged, [he owner, will be held responsible and charged for same. <br />(4) That ihe MUKILTEO WATER DISTRICT, its oKcers end agents, shall have the right of ingress afxl egress to go upon the premisos and properry <br />desaibed herein for the purpose of inspection, eonneeting or efisconnec6ng the service or (or such other puryoses as the service may require. <br />It is also understood during the Gme that any ol ihe water mains may ba autol service by reason of any emergency or improvements aulhorized <br />hy the DISTRICT, in any sveet or other lowtion in which they may have 6een laid, �he DISTRICT will not be requirad to turnish water during <br />the progress ol such improvements to any consumer whose supply may thus be cut otl, or 6e liable for any damages lor its failuro to do so. <br />(5) That the DISTRICT shall have the rigAt :o change tha rams et any time by Resolution, to tomporarily disconGnue the service to consumers, and <br />to install ihe meter (s) to register the water consumed. Tha DISTRICT shail not he held Iiabie lordamage by waterorother duse resulting fram <br />defeclive plumbing or appliances installed by the ownarorocwpant on the premisns supplied with water, and the laet ihat agen4s of ihe DISTRICT <br />may have inspec�d the plumbing and appliancss shell not 6e plead as a basis for recovery in case ol damage as atoresaid. II Ihe supply ot <br />water shall fail or be idlertupted by reason o( accident, low qaesqure.or otlier causo whatsoover, the DISTFICT shall not be held lia6�e for damages <br />nor shall such tailure or interruption lor any rnasonable tirtro bv,hel�f to mnstitute a breach of mntraet on the part of the DISTRICI'or in any way <br />relieve ihe consumor, whethar tenant or owner, ham por(orming ihe obligaGon of such lenanCs or owners conVact. Water shall bo used by <br />�� applicant only on the premises described herein. A naw a{�p�icafion shall be liled should water be desired for o�hxr premises although Ixated <br />� on land desuibed harein. ' <br />�,y; �(6) Thet �he DISTRICT recommends Inetallation of a pressun regulating velve. Appliea�t aeknowledges Informatlon as to the <br />reeommendallon and essumee lull responsibllity for I�ataHi� or falling �o install a preesura regulaling value an the wetcr system to <br />proteG it trom high pressure. `' <br />;tir ��(T� Tha DISTRICT utllizea eheck valvea at the meter to prevent wawr re�urning to ths Dlslrietn mains. The DISTRICT reeommends <br />Installelion of a thermal espanslon tenk to prevent eaeeal{vaprsasure build-up eaused by ths walar haater. Applieanl� acknowladges <br />informetlon as lo the recommendelion and essumss tull responsibllty tor Inatalling or falllop to Install a thmmel expenslon tank. <br />SERVICE ADDRESS: ���.� � �'� � y`� LOT NO. _�—` BLOCK <br />PLAT NAME: I�� G <br />CITY/STATE/ZIP: %�C'�`�� 9� !05� LEGAL DESCRIPTION: � <br />OWNEH'SNAME: ��-��"� H��' /�Y �� <br />OW�:ER�S AGDPESS: �-a 7� / iG C%'�ti � — <br />cirvisrAr�zia: ��-� �y4. q{y �/,Z/ � <br />I ho premises are to be u,ed as a <br />��� �d �s*�✓G� INFORMATION LETTER-GAVEiSENT: <br />� CHARGES: <br />(1) Service installauon 8 connection charge $ �� ��'�'�� <br />(2) Ganeral Facili6osconnocuon charge $ �l >'� ��v <br />(3) Olher 5 <br />Total amount received with applica6on S � 3�� �� <br />,/ � PAID <br />JUN � 31995 <br />� <br />� <br />MUKILTEO WATER DISTRICT <br />IT IS UNDERSTOOD ihat this Appliwtion, although sig�a0. shall not be bind�ng upon the MUKILTEO WATER DISTRICT un61 app;ave�6 ihe DISTRICT. <br />I, the undersigned, owner (cr representauve) ol the property deuribed:aboye, do hareby make applipucn for installafion of a -�// -inch <br />diammer water s�ypply service connectio0. including appurtenances, and all neces labor at my expenses. <br />Dated this � y day of,,'�f��.���'�� . <br />APPLICANTS SIGNATURE: l�+ u � "� " <br />ApplicanCs Name (please prinq: �� � � P� � � �� vL � �J S � � �3U � <br />Applicanfs Address and Phono Number: <br />�- 0 7/ ; � � ,� .�/ �i <br />APPROVcD: ���� /�� �� ?� 9�' <br />MUKILT WATER DISTRICT <br />B�: `���� � _ _�_ Date: i ��� <br />� —�__ ` — <br />