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. __.._:.i <br />MUY.ILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />_ APPUCATION FOR WATER / <br />Application No. 3S' �/ �U ����� ` No. _ G�� ��il� <br />Meter Size ��'4c/Gr�-T/0,(/ L�Number ot Units � Account No. ��U -/(�� /� <br />I hereby apply for water service and agree to be governed in accordance evith the resolutions, rules and regulations of the <br />I✓1UKILTEO WATER DISTRICT pertaining to water service, now or hereailer in eifect. The undersigr�ed as owner or <br />representative of ihe herein-described premises hereby agrees as follows: <br />(7) That the cost of any extonsicn of the waler sr.rvicc, renewal, replacement or repair to reach and serve �he property described shall be 6ome <br />by myself or assigns as owner (s) of the premises. <br />(2) That ail pipes, �vater measmin9 devices and otherconnecting equipmont upsheam 1:om the meter shall, after Ihair installation, 6e and become <br />thr. proporry ot the MUKILTEO WATER DISTRICT, subject ro all i!s regulations pertaining to water scrvice. <br />(3) That altcr installation, if ineter or metcr box and appurtenws aro buried or damaged, th^ owner, will bc held responsible and charged for same. <br />(4) Tha, the MUKILTEO WATcR DISTRICT, its officers andaponts, shall havc �he right of ingress and egress to go upon ihe premises and property <br />dascribed herein for Ihe purpose of inspection, connocting or disconnoctina the service or for such other purposes as Ihe service may require. <br />It is also understood during the time that any of thewamr mains may be out ot servico by reason of any emergency or improvements authorized <br />by ihe DIST9ICT, in any street orother localion in which they may have 6een laid, the DISTRICT will not he required to tumish water during <br />ihc prog�ess of such improvements to any consumer whose suppty may thus be cut off, or be liable ta any damages tor its failure to do so. � <br />(5) That ihe DISTRICT shall have ihe right to chanc�e the rates at any time by Resolution, to temporarily discontinue the service to consumers, and <br />to i rstall ine metm� (s) to register ihe water consumed. The DIS7RICT shall not be held liable for damagc hy water or oth er wuse re;ulti n3 Gcm <br />dofective plumbing ar appiiances ins Wiled by Ihe owne� oroccupant on Ihe premises supplied with waler, and the lact that agents ot the D ISTRI CT <br />may have inspected Cie plumbing and appliances shall not be piead as a basis (or recovery in case of damage as aforesaid. If the supply of <br />water shall fail or be interrupted by reason of accident, low pressure or other cause whatsoever, the DI STRICT shall not be held liable for damages <br />norshall such tailure or interruption forany reasonablo time be held to cons�itule a hreach of contract on the part of the DISTRICTor in any �vay <br />mlieve the consumer, whrther Ienant or owner, from performing the obligation of such tenanCs or owner's eontmct. Water shall be used by <br />A applicant only on the premises described hmein. A nmv application shall be fi;ed should water be desired lor other premises although located <br />+� on land described herein. <br />ir�r _ (6) That 1he OISTRICT recommends Ins�allation of o pressure regula�ing valve. Applicant acknowledges Informa�ion as to Ihe <br />recommende�ion and ussumes lull responsiblllly lor Installing or lalling to inslall a pressure regulatinp value an Ihe water sys�em to <br />protect II irom high pressure. <br />vt _(7) The DISTqICT utilizes check valves at �he meter to prevent water retuminc� to Ihe Districts mains. The DISTRICT recommends <br />inslallalion ol a thermal ezpansion tank to preven� ezcessive pressure bulld•up cnused by ihe water hea�cr. Applieanis ocknotvledges <br />� Inlormation as lo the,/recommendation nnd assumes �ull responsl6llty for Ins�alling or tailing to instail a ihcrmal expanslon tank. <br />SERVICE A�DRESS: /��J ���'�i�j.�= ��✓ LOT N0. BLOCK <br />_�'y � � . PIAT NAME: �r!/..c�� � ��=..,—y <br />CITI'/STA�P: / /'��n�`,/-- � <br />����?� s�. LEGt,L DESCRIPTION: � <br />Ol:"cR'S NANIE: .,L�.rw.c./ Ol�_ O � <br />0�4RJ�R'S ADDRESS: <br />CITY/STATEIZIP: � <br />G <br />. ' — — <br />Tne premises are to bc used as a _ <br />� '"��� INFORMATION LETTER-GAVE/SENT: <br />CHARGES: <br />(1) Service instailat�on & wnnection charge <br />(2) Genaral'racilities connection char9e <br />(3) Olhcr <br />Tmal amount received wilh appliwtion S— , l' !r✓ <br />IT IS LRvD=RSTOOD that ihis Applicalion, although signed, shall not be binding upon ihe MUKILTEO WATER DISTRICT until app�oved by the DISTRICT. <br />I, the undersic�ned, owner (or representative) ol lhe propeny described nbove, do here6y make apFlication lor installation of a���mch <br />diamemr waicr supply ,ervice connecti n includin� appurtenances, and all necessary la6or at my expenses. <br />Daled this _oT day of � g �/� <br />' \ � <br />APPLICANT'S SIGNATURE: / .. ��- - �� <br />Applicanfs Name (please prinq: !`1/� <br />- �App;ican`s Address and Phone Number. <br />APPROVED: _ �'i'i�a��'.-rp�-�--� <br />MUKIL WF.TER DISTRICT <br />9,,�-1 �� <br />� <br />-?�A ��7 �� <br />Data: � TS . <br />PAID <br />JAN 2 5 1991 <br />hRUI(ILTEO WAiER DISiRICI <br />C <br />��n <br />U� <br />� <br />� <br />� <br />c <br />� <br />Q <br />U <br />