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,_.� . . <br />� MUKILTEO WATER DISTRICT <br />SNOHONIISH COUNTY WASHINGTON <br />_ APPLICATION FOR WATER <br />ApplicationNo. ��_ (,{,Q�/—O�-y No. �� �%� <br />Meter Size ��� Num6er o( Units � Account No. f�.?D -/�n.� /� <br />I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations of the <br />MUKILTEO WATER DISTRICT pertaining to water serv!ce, now or hereafter in e(fecL The undersigned as owner or <br />representative of the herein-described premises hereby agrees as (ollows: <br />(1 � That lhe cost o� any extension of the water service, renewal, replacement or repair tc mach and serve Ihe properry descnbed shall be bome <br />by mysell or assic�ns as owner (s) of the premises. <br />(2) Tnat all pipes, water measurina devices and other connecting equipment upstream 6om tho meter shall, af�cr thoir installation, 6e and become <br />the proporry of the MUKILTEO WATER DISTRICT, subject to all its regulations portaining to water service. <br />(3) 7nat alter installation, if ineteror meter box and appurtences are buried ordamaged, Ihe owne�, will 6o held resp�nsibla and charged (or same. <br />(4) Tnat thc MUKILTEO WATF.R GISTRICT, its oflicers and a�ents, shatl have tne right of ingross and egress to go upon the premises and pmperry <br />described herein �ar the purpose af inspection, cnnnacting or disconnoctine� Ihe sorvice or for such other purposes as Ihe service may require. <br />It i s also undersrood during the time that any ot the water mains may be out of service by reason o( any emergency or impmvements authorized <br />by Ine DISTRICT, in , ny street or other location in which Ihey may have been laid, fho DISTRICT will not 6e required to fumish water during <br />the progress ol sur,h improvements lo any consumer whose supply may Ihus be eut olf, or be liable (or any damagus for its failure to do so. <br />(5) 7hat the DISTRICT shall have Iho right to change the rates at any time by Resolution, to temporarily discontinue the service to consumers, anc <br />tc in;tall ihn meter (s) to re�ister the water consumed. The DISTRICT shall not he held liable fo� damage by watcr or olner eause resulting from <br />de fective plomhing or appliances installed by the otvner or ocrupant on Ine premises supplied with �ti•ater, and the �act that agenis of the D ISTRI CT <br />may havo inspected the plumbin� and appliances shall not oe plead as a ba;is �or recovery in case of damage as atoresaid. II ihe suppty o! <br />kv�!er shall fail or be iNmrupted by reason of accident, low pressure or other eause whatsoever, �he DISTFICT shali not be held liablr, for oamages <br />nor shall such failure orin�erruption forany roasonable time be held lo constiWte a breach af wnhact on ihe part of the DISTRICT or in any wmy <br />wlieve'tio consumer, whether tenant or owner, from pedorming the ahliqation of suchienanPs or owner's wntracL Water shall be used by <br />'� aDplicant only on the premises described herein. A new applicaiion shall be filed shauld water be desired for other premises although located <br />on land descriocd hercin. <br />r.r _(6) That the DISTflICT recommends Installa�ion of n pressure regulating valve. Appllcant acknowledges IntormaUon as �o Ihe <br />� recommendation and ussumes full responsibllily for installin� or �alling to Install a pressure regulating value on the waler system �o <br />proicct It from high presnure. <br />�• . (7) The DISTRICT utilizes check valves nt Ihe mcler to prevent waler returning lo Ihe Disiricts malns. The �ISTRICT recommende <br />installation ol a ihermal ezpansiom m�k lo preven� excessive pressure 6uild-up caused 6y ihe water hemer. Applicanls acknowledgec <br />Inlormation ac lo the recommendalion and assumes lull responsihilly lor Installing or fa(Iing �o Install a thermal expnnsion tank. <br />S=RVICE l�DDRESS: 7� � 1 �D ��G_�''i.�„� ✓ LOT IJO. BLOCK <br />CITY/STA' <br />OWNER'S <br />OWNER'S ADDRESyS: %� L(/� i'�/� �_ /"�� y7��iU <br />CITY/STATE/ZIP: /���� �C-� �/�J f� �p y <br />. � .� <br />l"hr, pqremises are to b used as a <br />�/�CGU'..-C/,�� ��y+�.i�/i,...r� <br />PLAT NAId�� o���� ��,�,.y_�Ly.-3— <br />LEGAL DESCRIPTION: <br />i <br />INFORM�ATION LET'ER-GAVE/SENT: / � <br />V�� _ <br />CHARGES: <br />(7) Service installaiion 8 eonnection charge 5 � AS� �� <br />(2) General Facilities connection charae 5 ��O � Q(� <br />(3) Ofhcr S <br />Total ama,m received with appiication S � r/i�_ � �!� <br />IT I� Uf�'D�RSTOOD tiiit this App6cation, althou�h signed, sha11 not be binding upon �he MUKILTEO WATeR DISTRICT until approved by the DISTRICT. <br />I, n�,c undursianed, ownm (or repmsontativc) of the pmperty desaibed above, do hereby make application lor installation ot a��� <br />cil�meier wa{pr s�oply scrvice connec�ri' includino appurtenances, and all necessary labor at my expenses. - -inch <br />Uatcd this �-- day of .-i�f� . - - �;/ _ � 19 sj � . � .. <br />APPLICqNT'S SIGNATURe: �� <br />AppliwnPs Namc (pleare prinq: f/J L <br />�- AppiicanCs Addre;s and Phonc Number: <br />APPROVED: �i�i-� ��� <br />MUKIL����'�Q WATER DISTRICT <br />%i <br />�1'�� ��71�� <br />9 <br />r <br />Datc: ,_,[[Z� <br />� � <br />PAID <br />JAN 2 5 199] <br />TEO NJHTER DISTRICi <br />c <br />�6n <br />VI <br />..5: <br />� <br />C <br />� <br />c <br />c <br />Q <br />C <br />C <br />