Laserfiche WebLink
MUKILTEO WATER DfSTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPUCATION FOR WATER <br />Application No. � <br />Meter Size 3 � Number ot Units <br />�i <br />�i <br />q�'- ��-3 s� �; <br />No. .�-� l� <br />Account No. d�0' � 7G 770 O <br />I hereby apply (or water service and agree to be governed in accordance with the resolutions, rules and regulations ot the �� <br />MUKILIEO WATER DISTRICT pertaining to water service, now or hereatter in e(tect. The undersigned as owner or. � <br />representative ot ihe herein-described premise:+ hereby agrees as tollows: <br />(1) That ihe cost of any extonsion of the water service, renewal, replacement or repair ro reach and serve lhe properry described shall be bome ����. <br />by myself or assigns as owner (s) o( the premises. � <br />(2) That all pipes, water measuring davices and other conneetlng equipment upstream Irom the n'�erer shali, afler their inst�llalion, be and bemme <br />the property of the MUKILTEO WATER DISTRICT, subject ro all its repulaGons pertaining to water serviee. �, <br />(3) That after installa6on, if inetor or meter boz and appurtencos are buried or damaged, the owner, will be he�d responsible and charged for same. � <br />(4) That �he MUKILTEO WATER DISTRICT, its olficers and agenis, shall haee the right of ingress and eyress to go upon the premi;es and property <br />described herein for ffie purpose of inspecGon, connecting or dsconnoetlng the sarv:ce or for sueh o!hzr purposes as the service may require. �� <br />It is also understood during the ume that any of die wete+r meins may be aut ol sarvice by ieason of any emergency or improvements authorized <br />by the DISTAICT, in e�y street or o�er location in which they may hava been isid, the DISTRICT will not be requirad to fumish water during <br />the progress of such improvements to any consumer whose supply may thus be cut oM, or be 1ia61e fa any damages lor its failure to do w. <br />(5) That the DISTRICT shal� have the righno change Ne ratas at any time by Resoludon, to temporarily discon6nue the service to wnsumers, and i <br />to install the me:er (s) to registar the waterconsumed. The DISTRICT shall rwt 6e neld liable for danage by waterorother c�use resulGng hom � <br />detecliveplumbingorappliancesinstalledbytheownerorocwpantonthepremiseswppliedwithwater.andthofaathatagentsoftheDISTRICT � <br />may have inspected thn plum6ing and appliances shall not�be plead as a basis for recovery in case af damage as aforesaid. II the supply of <br />water shall fail or be intortupted 6y reason of accidant, low pressure orother cause whatsoaver, the DISTRIC i shall noi be held liablo tor damages <br />nor shall such failure or intertuption forany reasanahle lime be heid W consututo a breach of oontract on the part of the DISTRICT or in any way <br />ralieve the mnsumer, whether tenant dr owner, from paAorming the obliga6on of such lenanl's or owner's conuact. Wa1ar shall he used 6y <br />applicant only on the premises described herein. A new appliea6on ahall 6a liled shouid wator be desired lor otl�er premires allhough located <br />//y,-�7 on land desaibed herein. <br />ihT� ��• -(6) Thet the �ISTRICT reeommends Instsllallon ot a preseuro regulaHng valve. AppUcant acknowledges Information as m the <br />�recommendatlon and assumes full responsibtlity tor Inatalling or lalling to Install a presaure reguleting value on Ihe water ayslem to � <br />` protect it irom high preasure. <br />rvr _J (7j The DISTRICT utllizes cheek valves et the meier to pravent wate� raturning to the D�strlcts main�. The DISTRICT teeommends <br />Inatallatlonofalhermelexpensiontank�oprevuntexeeaalvspressurabulld•upceusedbythewetxheater. Applicantsecknowledgei <br />Informetion as to the raeommendellon and assumes lull rnponsiblity ior Installing r.r tailing io Install a thermal expenslon tank. <br />SEFVICE ADDRESS: II�I I/�v' � LOT NO. �� BLO� <br />,/ PLAT NAME: �[�- _ <br />CIN/STATEIZIP: Y�"y�'Lp� �A' 9�7� LEGAL DESCRIFTIOpN: �� <br />OWNER'S NAME: ��1(.�� ' `���1 � ��'�'� � <br />OWNER'S ADDRESS: 3'� G�e N <br />CITY/STATE/ZIP: J �� ��' qii%�,r�� <br />The premises are.ta be used as a � <br />��-��I,(i �4��s� INFORMATION LETTER-GAVFJSENT: 1I '� • � • <br />� CNARGES: <br />(1) S�:rvice installaGon & connection charge <br />(2) Generai Faalides connec6on charge <br />(3) Cilher <br />S �(i' � G ::� ,��� <br />s �/� �. �I� JUfV 2 7�gy� <br />S <br />Tocil amount received with applicaUon S ���� � MUKiLTEO WqiER DISTRI(!j <br />IT IS UNDERSTOOD that this ApplicaG m, although signq�, shall not be bindng upon the MUKILTEO WATER DISTRICT unel approved by tho}71STRTCT. <br />I, the undersigned, owner (or represenG.•tive) of lha property deuribed abovo, �b hnreby make applipfian for installation of a � �� _-inch <br />diameter wator supply service connec6on, includng appurtenances, and all neces labor at my expenses. <br />Dated this �? day ol �� ,1��_ � <br />APPLICANTS SIGNATURE: <br />Appliwnfs Name (please print): <br />' <br />ApplicanCs Address �nd Phone Number -1- v// / �� <br />APPR � �f�"''"�� <br />MU W�ER DISTRICT <br />�, ,..-�---� <br />g�: <br />�/ ��,r�� -/� �� <br />�`w/K /ULl/ <br />-'/,4 -�/ �� 9�- <br />�� y S' <br />Date: <br />