10823 17TH PL W 2016-01-01 MF Import

. .. - S4'• , _ .,�.. ... . MUKILTEO WATER DISTRICT SNOHOMISH COUNTY WASHINGTON APPLICATION FOR WATER m_D . � �" �? � �; Application No. b No. 93—/ia/ ' I�ieter Size �� Number oi Units �_ Account No. 1�2d'"�% %�lo� I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations oi Iv1UKILTEO WAfER DISTRICT pertaining to water service, now or hereafter in etfecL The undersigned as owne representative of the herein-described premises hereby agrees as tollows: __ athe �" r r or � (1 j i'hat the cost ol any exiensicn of the water service, renewal, replacement or repair lo reach and serve the properry described shal! be bomc by mysclf or assians as owner (s) of the premises. (2) That alI pipes, water measuring devices and other conneciing eq�ipment upstream from the mnter shall, after their instailation, be and become tne properry of the MUKILTEO WATeR OISTRICT, su6ject to ali its regulations petlaining to water service. (3) That ahcr insiallalion, if ineler or metcr box and appurtences nre buried or damaged, Ihe owner, will 6e held responsible and charged for same. (4'. That the NUKILTEO WATER DISTRICT, its ofticers andagents, shall have the right of ingress and egress to �o upon the premises and properiy descrihed hr.rcin for Ihe purpose of inspectian, connocting or disconnecting ihe sorvice or for such other purposes as Ihe servicr, may require. It is also understood during the time that any ol the water mains may be out ol scrvico 6y reason of any emergency cr improvements authorized 6y the DISTRICT, in any sheet or other localian in which they may have been laid, the DISTRICT will not be required to (umish waier during in:.� pmgress of such improvements to any consumer who:e supply may lhus he eut olt, or be liable tor any damages for its failure to do so. (5) Th�t the DISTRICT shali have the right to chanpo the rates at any time by Resolution, lo temporarilydiscontinue the service to consumers, and b instali Ihe meter (s) lo renister the water consumed. The D ISTBICT shall not be held liable lor damage by water or other cavse resutting }rom dr.ir.ctive plumbing orappliances installed by the owneroroccupanton the premises suppliedwith water, and the fact ihatagents of the DISTRICf ` may have inspecled the plumbing and appiiances shallnotbe plead as a basis for rocovery in case of damage as aloresaid. If the supply of • s:atershallfailorbeiNermptedbyreasonofacciden[,Iowpressurnarotheroausewhatsc:ver,theDISTRICTshalinotbrheldliahlefordamapes nor shall such fciWre or interruption lor any masonable Iime be held to eonstiWte a breac.i af eontract on Ihe part of the DISTRICT or in any way relir.ve the wnsumer, whether tenant or owner, Irom performing Ihe obli�a�ion ol such tenanCs or owner's eontract. Waler shall be used by applicant only on the premises described herein. A new application shall be fiied should water be desired lor olher premises although located �/ an land described herein. uat .��(�9j�fhat the DISTRICT recommend: installation of a pressure regulating vaive. ApplieaM ucknowledges information as to the recommendation and assumes lull responsiblllly for installing or la(ling to Install a pressure regulating value on Ihe walcr systmn to /�olect it fmm hic�h pressura - mi �� 7) The DISTRICT utilizes check valves al Ihe meler to prevent wa�er rclurning lo the Districts mains. The DISTRICT recommends �� inslallalionolalbermalezpanslontanktoprevenlexcessivepressurebuild-upcausedbythewalerhealer.Applican�sacknowledges i ,i inbrmation os to ihe recommendation and assumes fuli responslbiity for Instailing or falling �o Install a Ihermal expansian tank. S=RVICE ADDRESS: y�� / �/�✓` ��L� LOT NO. _ � � _ BLOCK _ �.��-� =�, ,/'/ � y�-y PLAT NAME: ��=�✓`+��"" ��– � CITYlSTA7E21P: t�i i /:'� �'� X.�G7' LEGAL DeSCRIPTION: r.�CV �fi / �' / U . / . . T 6�� . OWNER'S NAME: /%%%/v/ `� OWNER'S ADDRESS: GTY/STATEiZIP: � - S'� �=�-�� y The premises arc �o be used as a� ,p ---�'��f�' ��'�'�'� INFORMATION LETfEH-GAVE/SENT: �%""��` — � CHARGES: � P�D (1) Service installation & eonnedion��chargo S� /!/v� �� (2) General racililies conneaion els�rge � S ��' �[J� G':'% JUL U 9 1993 �a� omer ' .; 5 MUfSILTEO WATER DISTRICi `' i//� Jr/ Total amount received with application 5 ;T IS l!I:U=RS700D th�t this Applicauon, althounh signed, shail not be binding upon the MUKILTEO WATER DISTFICT un;ii appr.ovqd by the DISTRICT. I, Ihe undursigned, owner (or representative) of the properry described above, do hereby make applicution lor instoilation of a�/� -inoii a�amoter wa;er,supply serviu� connection, i�cluding appunenances, and all neeP.ssary labor at my expenses. Datcd Ihis _"" � � day of —�} �/ (- ! �'– .19 �';� APPLICANT'S SI�NATUR'c: �'/ r'^` �-�� / Applicanfs Namr (Pieasc ;;ini): –` � ( /` � L � �'�/ / i:' "v Applinnt3 Address and Phone Numbrr i�� /�' '��% �- APPROVE�,: �_____-��-��'� ^'" --�—' �4UKIL .�O TER �715TRICT ��' 9y 'll•'_�`"�""�— i '� i'= /;%{� i� � r� -=-`1.r"/> > =' f�=. >/�- o��: � �3