9825 18TH AVE W 2016-01-01 MF Import

_-:J MUKILTEO WATER �ISTRICT SNOHOMISH COUNTY WASHINGTON _ APPLICATION FOR WATER Application No. �-� lvG� �� a� Meter Size __ �1 �� O^ Nurnber o( Units I hereby applv ior water service and agree to be governed in accordance with ih Iv1UKILTEO W,4TF.R DISTRICT pertaining to water service, now or herealter i repres.cntative nf ttie herein-described premises hereby agrees as follows: No. �'1/-6'77 Account No. _�O ��/�o� e resolutions, rules and regulations oi ihe n eftect. The undersigned as owner or �7? That the cost ol any extension of the water servicq renewal, ieplacement or repair to reach and serve Ihe property described shali be borne cy myself or assigns a; owner (s) of the premises. (2) Tiiat all pipes, water measuring devices and other connecting oquipment upstream (rom ihe metor shall, afmrihoir installation, be and become ite praperty of the MUKILTEO WATER DISTRICT, subject to all its rngulations pertaining to water service. (3) '� nat aher installalion, if ineter or meter box and appurtencos are buried or damaged, Iho owner, will be held responsihle and eharged far ,ame. (4) "i nat Ihe MUKILTEOI"JATEfl DISTRICT, i�s officers andapents, shall havc thc right of ingress and egress to goupon the premises and propeny desai6ed herein tor the purpose of inspection, connacting or disconnocting Ihe service or (or such other purpases as ihe service may require. I�. is also undersrood dwing the time Ihat any of the water mains may be out ot service by reason of any emergency or improvements authorized '�y the DISTRICT, in any street or other loc�tion in which they may have been laid, ihe DISTRICT will not be required to fumish water during the pro�ross ol such improvemenis to any consumor whose supply may ihus be cut ofl, or be liable lor any damag�s for its failure ro Co so. (5) That the DISTRICT shail have the right �o change ihe rates at any time by Resolution, to tempora�ily discontinue the service to consumers, and to i nstall ihe meter (s) to regisler the water consumed. The DISTRICT shall not be he Id liahle lor damac�e by wafer ar olne� cause resulting Iram dofeclive plumbing or appliances installed by the owner aroccupant an the prem ises supplied with vrater, and Iho fact tha[ agents of the DISTRI CT may have inspected the piumbing and appliances shail not be olead as a basis for recovery in case ol damage as aforesaid. If tne supply of wa ter shall tail or be i nterrupted by reason of accident, low pressure ar other cause whatsoever, the DI STRICT shall not be held 1ia61e Fer damages nor shall such failure or interruption forany rea,anable time he heid to constitute a breach ol cantract on the part of ihe DISTRICT or in any way relieve the consumer, whetner tenant ar owner, Irom performing the obligation el such tenanYs ar awner's contract Water shall be used by appliwnt only on the premises described herein. A new applicaiion shall be filed should water be desired lor other premises alihough located on land deseribed hercin. �-._ (6) That the DISTRICT recommends Installallon ot e pressure regulaling valve. qpplicant ucknowledges fnforma�ion as lo Ihe recommendation and aasumes lull responsibllity (or inslalling or �alling to Install a pressurc regulaling value on �hc water sy,tem lo prolecl it from high� pres,ure. ir. __(7) The DISTRICT utilizes check valves ol the meler ta prevent waler returning to ihe Disirids mains. The DISTRICT recommends installation of a thermal expansion lank to preventexcessive pressure build•up eaused by the wa�er heater. ApplicaMs acknowledges _ informnlion a, �o iho recosnmendntion and assumes full responsl6ilry for Installing or falling to Install u ihermal ezpansion tank. SERVICF :,DDF�SS: ��,!.�S I� �/�iy„G �,/ LOT NO. BLOCK CITY/STA7E'ZiP: OWWER'S D 6 � r r--- PLAT NAMc: �_�� LEGAL DESCRIPTION: OWNER'S ADDReSS�:"� JU/J �/Yi�� /,2�iF {!'�r.,Q� CIiY/STATciZIP: /� .��:��__r��;Q L/�{��!/ -"�----'_- � � Thr premises aro ro be used as a � �� 6�� INr'ORMATION LETTER-GAV��S=NT: ' � CHARGES: �/ (/"/ �-J (i) Service installation & connection charge 5- � 97i � O (2) Gencral Facilitics cannection chargc 5 � y� v. � v (3) Other � Total amount rcccived with aoplication S 2�;� 9. /� I' IS UNDERSTOOD that this Appliwtion, ahhough sianed, shall noi he bindin9 upon the MUKILTEO WATER DISTRICT until approved by the DISTRICT. I, �i�e undersianed, owner (or representative) of the property describcd above, do hereby make application lor installation of a �// -inch clamo�er wa�er su I service eonnec �, mduding appurtenances, and al� nece sary labor ai my expenses. 'Ja�ud this � �Y day of �.C�ft�✓'_�_�_ .19 G%� . APPLICANT'S SIGNATURE: X ApplicanPs Name (pleasc print): �i% L� �/l f�Tf�/ti Applicant; Address and Phone Number��!/ /. `'� APPROVED: �.�/��.�-.�...� i/fJ 7�/�-!J(J MUY.ILT WATER DISTRICT „ "" �� Date: � 7� i/ �'AID JAN 2 5 199i MUKILTEO V�'HiER DISTkIt„