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<br /> MUKILTEO WATER DISTpICT
<br /> SNOHOMISH COUNTY WASHINGTON
<br /> APPUCATION FOR WATER O
<br /> �,pplicationNo. �v No. _ �T�� �v
<br /> � " O
<br /> Meter Size �___ Number of Units _�___ Account No. �2L> — �{�' _�
<br /> �
<br /> I hereby apaly lor water service and agree to be govemed in accordance wilh the resolutions, rules and reguiations of the �+CJ
<br /> MUKIL7E0 WATER DISTRICT pertaining to water service, now or hereafter in etlect. The undersigned as owner or Q
<br /> representative of llie herein-described premises hereby agrees as lollows: �
<br /> f I) That Ihe cost of nny axtonsion ol tho wnmr snrvico,renmvnl. rcplucemr.m or rupni�to roeeh and sorve the propo'ty doscn6od shxll be home �
<br /> hy mysell or nssic�ns es ownor(s) ol thc promisos.
<br /> (2) Thot oll piprrs,w�ter mensunng dnvi�s xnd othur connnctmp opuipmont upshanm from the morer shall,nhor thoir installnnon,be end bowme
<br /> C
<br /> thc property ol thc Ml1KILTEO WATER DISTRICT,suhjoct to nll Os mpulations portn�ninp to weto�servico. �
<br /> i�) That nhnr installation,If mneer or metar box anC nppurtoncos em 6unod or damapod,th�ownor,will M hold rosponsi6ln and chnrgAd lor same
<br /> �4� TnmiheMUHILTEOWATERDISTRICT.iisollicorsenJeponts,shellhuvethoriqhtafingrocsendegrassmgouponlhopremisasendproperry �
<br /> d�.:sciitwd hornm for the purposo ot inspoction,connectinp or disconrrecOng tho eorvica or for suth otho�pu�posos es Ihe snrvico mny�oquve �
<br /> I�is�Iso understood Awing the timc thn!nny of the warer meins mey be ou10l eervice by rnaeon of eny emerponry or Improvemen�s outhorizoc �
<br /> hy Ihe DISTRICT, in eny slmol or olhor locnuun in which thoy mny hnw bnan laid,tho CISTRICT will not bo roquirod to Iumish wa�er dmmp
<br /> tho progmss of sur,h Improwmenta lo wny consumer whose supply mey lhus he cul oN,or be liahlo lor any damnpos lor ils failum Io da so �
<br /> 15 i Tna!Ihn DISTRICT shnll hnw tho nght to chenge the ra�os et eny hme by Rosnlu�ion,to�omporedly discontinur tho snrvico�o con6Ume�s,nnr
<br /> h� n,sliltthomntm�s� torogislorthewntarconsumod ThoD15?RICTshnllnotbaholdlia6lefordemngebVwotoro�othorrausoresUltingfrom
<br /> an!ecuvu p!umhinp or npplinnms Inslnllnd by tho ownor m ocapent on[he promisos 6upp0od with Walor,end tho taet Ihnt ogonts of ihv D ISTRICT
<br /> may hnve inspecind�ho plum6ing nnd npphnncos 5hnll nol be ploed ns o 6nsic lor rocovory in caso ol domege as qlorosaid II Iha supply o!
<br /> wNor shall I�il or ho intonuplad hy mnson ol acudont,law pmssura o r othor cnuso whetsarvor,lho DIS f RICT shnll not bc hcld IinClr lor tlmm�ges
<br /> r.,.r shall such tNluro or inlormplian for any roasonPbM nmo bc hold lo constiluto e brvech ol comract on tho pnrt ol tho DISTFICT or in any wny
<br /> rnhovc Iho arnsumor,whothor I�nnnl or ownnr, from pndorming iho obligelion ol such tononl's or nwnoYr.coMrecl. Wntor shall M� usvd by
<br /> npp6cnnl only on Iho promisns tlosaiboA hornm A now apphcanon shnll be Itl�d should wator be dosimd lo�othor promisos nhhough Iocnlod
<br /> on IanA duscrihixf hercin
<br /> e.� -�; � (5) Thet Ihe DISTRICT recommenda Inelelletlon ol e pre�suro reguleling velve. Applleanl ecknowledgas Inlormetlon es to Ihe
<br /> re�ommendallon and eesumes lull rec�onslblllly tor Inelellfnp or lelling to Inetall e preesure tegulaling velue on ihe weter�ystem to
<br /> pro�ect Il lrom high prnneure.
<br /> ��.i ?!',^.'(7� 7he DISIA��T u111fxac check velveo et Ihe meler �o prevent walar rewrning �a Iha Dlslrlcls melna. The DISTRICT recommends
<br /> - inelnl1n11onolalhermnlexpnnalonlpnktoprevenleKcoedvepres�urebulid•upcewsdbylhewderheeter. Applieanlsecknowledgee
<br /> Inlormellon es lo Ihe recommendulion end���umes lull reepon�lbllly lor Inslalllnp or lelllnp to Inslell� Ihermel expenelon tenk.
<br /> �;rrivicE noor�F:;s _ /:'.�,:4 _,�r. °` T
<br /> r �--r �� Y ��.___ LOTNO ._y�1 ____ BLOCN ___.__
<br /> ._.. .__ '�ALiYt'.`l j:' �/J. y�a'��_ PLAT NAME. S!u �Fh'O :-"Y ,,��/i'r r-,cr s __
<br /> GiTY/STATE/ZIP _ LEGAL DESCRIP710N.
<br /> nVJNER'S NAME�. `�'��_.�� ---- -
<br /> '�WNER'S ADDRESS. _r�i1J 3 J"^j' �I'r'i � �l -- � "� �'.
<br /> �:IT\'/5?ATE'ZIP. ���t,�'A�l� . �,fJ� ��+ �)�
<br /> .�� --_— _ —..
<br /> 1 hc pmmisos arc lo bc usrcl nr.n ____ ._ -..— 1--.-. ti
<br /> �J � ,
<br /> -- --- -- INFOqMA710N LETTER-GAOi�.'Si_NT ._W'�IkC'_ t���r�'�, ����
<br /> CHARGES: n A [D
<br /> f:�J FL'.
<br /> (t�Sarvice inslnllalion 8 connection charae S _ . � _ .
<br /> / �/ x' ,'' ' OCT 2 0
<br /> f:l Gunoral Feriliuoa eonnocuon cherge s __.__ 199g
<br /> . 13)Othnr $
<br /> Total�moum tecervod with applimGon S A '�" ����?�_.��UKILTEO WATER DISTRICi
<br /> �" r!�.lh::�!-RS700;�thetlhisqpp6cntion,ehhouqhsigned,shallnotbobindinpuponlbeMUKILTEOWATERDISTRICT�ntilapprowd6yfth DISTRICT
<br /> �/i � i (
<br /> �. !'�e untloraipaoA,ownm(or roproeonlatiw)ol thc pioporty tlosenDnd ebovo,do homby mnh��appL,-almr lo� insLJlaLon o! n �'�'- -�nc��.
<br /> c;rn�nor wni�r bupply aeMa wnnocNon,mduding e Purtenances. end ell rwcessery labnr et my o�pe:mes ' �
<br /> :';nutllhis _�s'V) duyol � o/�ji____ JB °��/
<br /> n; ��L "�N7'S SIGNA7UpE� `-��/�/���i�u'��.�„�/,��`�...
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<br /> n�q�,L_arfe ,, imo (ploase pnnq� __��:1.V^�r- �'�— �`I._"�E_��,`..�_____- __. ..
<br /> Apnlc,�r�. AAdms� antl Ppone Numbor _ �..^ � C .i ' A
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<br /> M,!KIL i 1A WATER DISTRICi �o�t�,;,6,� ,�, p�d f � // �„� �„ Srn v.�e
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