9613 18TH AVE W 2016-01-01 MF Import

Applicati�n No. IdeterSize J�`' � MUKILTEO WATER �ISTRICT SNOHOMISH COUNTY WASHINGTON APPLICATION FOR WATER Number oi Units � . � rr t\ ��/ No. _(l 5 (� � I I � �j — Account No. —!.� U � � I hereby apply for waler service and agree to be govemed in accordance with the resolutions, rules and regulations of the MUKILTEO WATER DISTRICT pertaining to waler ,ervice, nov+ or hereailer in eHect. The undersigned as owner or representative of the herein-described premises hereby agrees as follows: (1) That ihe cost of any extension o� the water service, renewal, replacement or repair to reach and serve the properry described shall 6e bome by myself or assigns as owner (s) o( the premises. (2) Thm ail pipes, water measuring devicr,s and olher connecting equipment upsVeam irom the moter shall, aftor Iheir installation, be antl bemme the r,roperry of the MUKILTEO VJATER DISTRICT, subject to all its regulalions pertaining to water service. (3) 7hat after installation, if ineter or meter boz and appunences are buried ordamaged, the owner, will be held rosponsible and ehargod for same. (4) That ihe MUKILTEO WATER DISTRICT, its olhcers andagonts, shail have tho right ol ingross and egross to go upon the premises and propehy descri6ed herein for �he purpose of inspection, connacting or discnnnec6ng Ihe carvia: or for such other purposcs as tho service may require. It is also understood during Ihe time that any of the walcr mains may be out o� cervice hy reason ot any emergency or impmvements authorized by the DISTRICT, in any street or other location in which they may have been laid tho DISTRICT will not be required fo �umish water during the progros, of such impmvements to any consumor whose supply may Ihus be cut ofi, or be liable for any damages for its failure to do so. - (5) Thnt ihe DISTRICT shall have Ihe right to chango Ihe ra�es at any time by ResoWtion, to tomporarily discontinue the service to consumers, and to in;tall the mr,ter !s) to registcr the water consumed. Tho DISTFICT shall not be hold liable for damage by water or oiher wuse resvlting from dafective plumbing or appli �nces installed by the ownor or occupant on the premises suppiiod with water, and iho fact that agents o! the U I STRI CT may have inspeded the plumbing and appliances sh�ll not be plead as a basis tor rocovory in ease of damage as nloresaid. If the supply of wa�er shall fail or be interrupted by reason ol accident, low pressure orolher causo whatsoever, tho DI STRIC'i shall not be held Iiabie br damaaes nor;hall such failure or iMermption for any roasonable time be held to wnstiwte a breach of contract on Ihe part ot ihe DISTRICTor in any way relieve the cansumor, whether tenant or ownar, lrom performing the obligation of such tenanCs or owner's contract. Water shall be used by appliwnt only an ihe premises described herein. A new applicaiion shall be filed should wa�er 6e dasircd for other premises although locaied on land described here'in. i�;. (G) Thal Ihe DISTRICT recommends Installa�ion ol a pressure regulating valve. Applicent acknovdedges Informallon as lo Ihe � recommendotion and ossumes �ull responsibllily for Inslalling or lolling lo Instull a pressure regulating value on Ihe waler syslem to protect II irom high prc.surc. n.- __(7) The �ISTflICT ulilizes check valves at Ihe mmer Io preveN walm roturning Io ihe Distric�s malns. The DISTRICT recommends instnllation of a thermal ezpnnsion Iank to prevem ezcessive pressuro build•up coused by the water hentec Applicants acknovAedges informnUon as to tho recommendotion and os,umes tull responslblliy for In>tnlling or talling to Instnll e Ihermal expanslon �ank. SeRVICe ADDRESS: � ' . l."� ' � - LOT WO. ._. BLOCK ' � ...- r � �. CITY/STATE/ZIP: - '��r OWIJER'S NAME � �'�16 �' � "�/J`�. f:., l L� �: J✓i�.. �' _ : r �,: OWN'cR'S ADDRcSS: � � " CITY/STATGZIP: �� ' ,��:1' �' , , The pmmises are to bo used as a PLAT NAM"e: � - _ ..,- � - � � � LeGAL DESCRIPTION: �..- - ,� %1 INFORMATION LETTcR-GAVE�SENT: CHARGcS: (1) Service insta!!anon G connection eharge 5 (21 General Faciluies eonnecuon eharQe S (3j Olher Total amount received with appiiwuon IT IS UNDERSTOOD that ihis Application, atthouah signed, shall not be binding upon ihe MUKILTeO WAT'eR DISTRICT until approvod by Ihe DISTRICT. I, ihe undersigned, owner (or represen�ative) of the property described nbove, do hereby mako appiica�on fo: installaGon at a �� -inch ciiamoter waier supply service connection including appurtenances, and �II necessary lahor at my exponses. D��ed this " da)' ol �� -'� �� , � "" � APr LIGANT'S SIGNATURE � ' PAID Applicanfs Name (please prinq: — Appii:�nt's Address and Pnone Numbert APPROVED: MUKILTEO WC�TER DISTRICT B�, ::%�. � i^�..-� (�AY ? 3 �003 ' , ft1UKIL7E0 WATER �!SiFI( � Date: � ' - - �,