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...�� i- �. , ' .. .. . . fi r _ . + ' <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />ANPLICATION FOR WATER <br />Appiicalion No. /�v <br />Meter Size �� � Number oi Units �_ <br />No. ��G — ���f5 <br />AccountNo. '-���"/"�7(a�`� <br />I hereby apply for water service and agree to be governed in accordance with ihe resoiutions, rules and regulatior.s oi the <br />MUKILTEO WATER DISTRICT pertaining to water service, now or hereafter in eitecl. The undsrsigned as owner or <br />representative of the herein-described premises hereby agrees as follows: <br />(t ) That the cost ol any eatansion ol the water service, renewa�, replacement ar repair to reach and serve Ihe propnrry described shall be bome <br />by mysell or assigns as owner (s) oi Ihe premises. <br />(2) That all pipes, water measuring devices and other connecting equipment upstream from the morer shall, atter Iheir installalion, be and bernme <br />the pmperry ot ihe MUKILTEO WATER DISTRICT, subjec[ to all its repulaGons pertaining to water service. <br />(3) 7hat after insWllation, it meler or meter boz and appurtences ara buried or damaged, tho owner, will be held responsible and charged lor same. <br />(4 ) That the MUKI LTEO WATER DISTfIICT, ils otfiwrs and agonts, shall have the right of ingress and egrass to go upon tho premises and property <br />desaibed herein for the purpose of inspection, eonneeting or disconnecfing the iervice or for such other purposes as the service may require. <br />It is also understood during the time that any ot �he water mains may be out oi service by reason of any emergoncy or improvemenls authorized <br />hy the DISTRICT, in any sVeet or other location in which they may have been laid, the DISTRICT will not be required to furnish water during <br />the progress ol such improvements to any consumer whose supply may thus be cut Qfl, or be liahle lor any damages for its failure to do so. <br />(5) That the DISTRICT shall have the right ro change the rales a[ any �ime by Rnsolution, to temporarily discontinue iho service to consumers, and <br />to install Ihe meier (s) ro register the water consumed. The DI9TRICT shall not Le held liable for damage by wateror other cause resulling from <br />defective plumbing or appliances installed by the owner or occupanton ihe premises supplied with water, and the fact ihat agents o( tho DISTRICT <br />may have inspected the plumbing and apgliancqs shall nat be plead as a basis tor recovery in case of damage as aforesaid. II the supply of <br />water shall lail or be intenupted by reason ot accident, low pressure or other causo whatsoever, the DISTRICT shall not be held liable tor [lamages <br />nor shall such tailure or interruption tor any reasonable time�b�ld to constitute a oreach ot contracl on the pan ot the DISTRICT or in any way <br />relieve the consumer, whather tenant or owner, irom performing the obiigation of such tenar.Ys or owner's contract. Water shall be used by <br />applicant only on the premises {i ibed herep. A new app�eGon shall be liled shouid water be dosired lor other premises allhough located <br />7` en land desaibed herein. ��' ' ��. '� a' <br />./ r,;; ,�(6) Thet Ihe DISTniCT :ecommends Installallon of a pre:sum regulating valve. Applicant aeknowledges Intormetlon es to the <br />1� recommendeiion and assumes tull rejpo��l�fnty Inr IpstAllinp or felling to Install a prossure regulating velue on the water syslem to <br />/n protect it from high pressure. <br />�j i�:� '` ��(7) The DISTRICT utilixes check valves at Ihe.meter lo yrevent water returning to the Dlstdcts melns. The DISTRICT reeommenda <br />/� InslallatlonofalhermalexpansloliAenk�opreventezcessiyepresaurebulld-upeautedbythewatorhaater.Applleeniseaknowledges <br />informetlan as to ihe recommendellon and assume`s� luIll respons1611ty for Installing or lalling to Inalall a Ihermel expanslan tank. <br />SERVICE ADDRESS: � V_� I I Y� f�� !N, LO? NO. �`� _ BLOCK <br />PLAT NAME: �� L � ����� <br />CITY/STATE/ZIP: � IIF R� ^ Wl�'�'I LEGAL DESCRIPTION: __ C , / <br />OWNER'SNAME: �F�LI�H .IL.YILA•��I'� �I J�% �(j� �V � <br />OWNER'SADDRESS: ���� �� JLv i-I �.:c IUl'V <br />� 1 <br />CITY/STATE/ZIP: J�]IJIU�)i il� �i �. � I"t�d � <br />The premises are to be used as a <br /><�1,!(1✓�� C//l'1 � Il INFORMATION LETTER•GAVE/SENT: ���_ <br />� CHARGFS: I /� <br />(1) Service installation & wnnection charge 5— / Uv� G'" <br />(2) General Facilities connec�on chargo $ � �� � �G� <br />(3) O�her $ /y <br />Tolal amoun� received with applicaGon $ ��' �J T� � U <br />IT IS UNC ERSTOOD that �his Appliw�ion, although signed, shall not 6e binding upon tha MUKILTEO N�ATER DISTRICT unfil epproved by ihe DISTRICT. <br />I, the unoersigned, owner (or representative) of the propeny desciibed�5bove, do hereby make applica6on lor inslallation of a � -inch <br />diameter watcr supply cervice connectioq. including appurtenances,.and all necessary labor al �ny exponses. <br />Dated this � r -� day oF.�r ; �;) ��;w L/� � i � � .'�/19 �, /,: <br />APPLICANT'S SIGNA <br />ApplicanCs Name (please prinQ: � <br />ApplicanYs Address and Phonr: Number: <br />APPROVED: ����i�'iv�r��;_�yn 'ra.<y-,r <br />MUKILTE ER DISTRICT <br />By. ti"�--��- Date: � <br />/� PAID <br />/.� V � „ <br />MAY 3 19�6 <br />MUKILiEO WATER DISiRICi <br />� <br />� <br />♦ <br />