|
. ....- . .....��T.��t �.�TX. a - .. r. ... ., ��...r��/�4„wtSY�LT:�pY. •.;tr�aC+('..-p.^, J''!f?'•Ti'S.�-¢ �
<br /> � . . • . , . 1.: r. +-� �4t FO'�
<br /> . `
<br /> MUKILTEO WATER DISTRICT
<br /> SNOHOMISH COUNTY WASHINGTON
<br /> _ APPLICATION FOR WATER
<br /> Appl�calion�Jo. �--� No. —���0���.-,__ �
<br /> Meter Size �i,�__ Number ol Units � _ Accou tt No. ���U-/TSU!/S aU O
<br /> 1
<br /> I hereby apply for water service ano agree to be governed in accordance with Ihe resoli,iicns, rules and regulations of the �
<br /> MUKILTEO WATCR DISTRICT pertair,ing to water service, now or hereefler in effec . The undersigned as owner or O
<br /> represen?at�ve o1 ihc herein-described premises hereby agrees as follows: �
<br /> (1� Thot Ihe .;ocl of nny ertrnsion of the welor enn�...e, ronewal,mplammom or ropair to mach and srrvv the pioparry dexcnbcd shell be bame
<br /> 6y mysclf o�nssigns ns �wnm(s) ol the pmmisns �
<br /> (2) That nll pipos.wator mer sunng dnNms enJ othrr connocGng o�uipmoN upslmom hom the metm nhaV,ehar thelr Installetion,be and become
<br /> the propelty of the MUKILTEO WATER DISTRICT,r.ubjocl W nll Rs ropulxeons portnining ro wator service. �
<br /> (31 Tr�nt nhr.r Ine�allahon,i!metor or motor boz end eppu7nnoos ern buriod ar damngnd,Ihn ownor,will!x hold rosponsibla end ehorged for samo �
<br /> f4) Tnanhr.MUKILTEOWATERDISTRICT,ItsoNioncnndngnls,�hal�hnwtheriphtofingmssendegrotstegouponthepremisosnndproperry �
<br /> d�sscritwd hmein for tna purposo ol inspoction,conneclmp or disconnecGng tho sarvix or�or su;h othor purpos�s es the sorvice mny roquiro
<br /> It i s Nso understooA during iho hme m�nt eny o�Ihe watFr meins mey be oul al service hy reason ol any omergancy or improvnments authonaed �
<br /> by Ihc DISTRICT,in eny stmat or othrr.locohon in wnich thoy moy he�e Man leid,tho DISTRICT wilt not be reqvirod to furnish watar durinp �
<br /> Inr progross ol such imp�owments io any consumer whene wpPy mny Ihus 6n cut oM,or be lieble la eny dnmagos for its failuro to do so. l
<br /> (5) Thnt ihn DIS'qICT shnll haw tho right ro chnngc.Lhn retos e�eny hma 6y Ro:elirtian,to tomporedly discentinue Iho survice to consumers,and
<br /> Iemstnllthemmer(s) tornpishrthewemrcansumed ThaDISTRICTshallnotbohnldlinhlolordemnpcbywnlororathorenusArosullinglrom
<br /> dnlnctrvc olumhing or applianrns inamlled hy Iho ownor or ocwpnm on tho promisns suppliod wilh wnror,end Iho la�t Ihot agonls ol thc DISTRICT
<br /> may hnve inspnclod Ihe plumhing nnd npplinnces shqil nol 6o plond es e 6nxis lor rucovory in case of dnmago xs nforosnid. If Iha supply of
<br /> wntnr snnll Inil or 6n inlorrvpteA by ronson ol acddont,low pmssuro or othw eauso whnlsoovvr,thx DISTRIC T shull n�[6o hold liablo lor d�mnpos
<br /> nor shnll such Inilure or iMnrmption lor nny ronsann6lo ume be held to constiwto a 6reach ol mnlrnot on Ihe pnrt of tM DISTR:CT or in eny way
<br /> roLovo Iho mnsumm,wbnmar tonnnt o�axnar, from podorming tl�n o61ign6on�I such tnnnnCs or ownar's contrna. Wntor shnll bo usnj by
<br /> npPlicanl only or�tho p�omisos dosaibnd hormn A now epplicnuon shnll hr,lilod should walm bv Josirnd br olhar promisos although Icrntod
<br /> nn lantl dasaihod haruin.
<br /> wi _y��.(6) Thel ihe DISTRICT �eeommend� Inelelletlon of e procsurs �egul�llnp velve. Appllcant �oknowladge� Info�mellon an to ihe
<br /> rocommendullon enA ae�umee lull renponelblllly lor Inetelllnp or lelting lo Instell e prea�ure r�puleting value on 1he weler�yslem to
<br /> pro�acl li 1 .�m blgh prneeure.
<br /> yI.�T) The DISTh��T ullllios chack velvas ai Ihe m��er to prevenl wale� relurning lo Ihe OI�IrIc�s msln�, Thn DISTRICT racommends
<br /> � InntelleY�nolelhermeleRpenslontenktoprevenleioes�lvspres�urebulld•upceu�edhylhew�lerhealer. AppllcanlaeeNnowledpee
<br /> Intormelion as to Ihe rocommandellon end e��umes tull ra�pon�Iblity far Inslalllnp or lalllnp lo Inste�l� Ihe�mel expanelon Innk.
<br /> si-q1qC.F ADDRESS __���p'_�� S_T_S" /j/ __ LOT NO _� I BLOCK
<br /> -_- -_ -- �f/ �/f�� %f 1,[�����IfSdLAT NAME. 7vUT�/C'C� i TV' ["1/S%��TS'
<br /> C11Y/STATVZIP� ____ _ LEGAL DESCRIPTION: �
<br /> c�NlNER'S NAME� _�✓�L_ PJ Q�,� Ey ' `'C"�
<br /> � 5---- —
<br /> OWNF.R'S ADDRESS. �.`�`D ?� /e�Z�'f�T_„yl,�(J
<br /> ':ITV,�STATE/ZIP. ___�(1��F17_—,:S/�._.�'�c'.(��� —
<br /> . /
<br /> Thr prr.mis�,s nre In bo used ns n ____—'-1_'� _. _ '__'___-- ________—___
<br /> �------�-- — INFORMATIONLE'�TER-GAV6'S"KT . ___ _ . _ .
<br /> CHAqGES pAID
<br /> IO/ �
<br /> ;1�Sorvica inslullntion 8 connoclion charge 4 ___.__�:.���a-_�_ ___
<br /> (.^I Ganoral Faciliuos connocUon cherge s /�������-� _ OCi 2 0 1999
<br /> (3)Olhor s
<br /> To1el amounl recorved wilh epphw4un S _- ��_^�a"'�:J MUKILTEO WATER DISTRI',',I
<br /> ;t IS l IND;RSTOOD that ihir Apphcatmn,enhaugh signed,shall not bo bind�np upon Ihe MUKIlTEO WATER DISTRICI unlil approvudby 1n�I�TRICT
<br /> /
<br /> I "ie unda!s�gnod,owner�or roprosontntrvtq o��he pro0erty dneerlbod ebovo,do he�o6y make epplirn0on lor mst.Jlanon o!n _._ _-�! �inch
<br /> a.,nnumr woinr supply¢ornco connoa�un, includ�ng nppunonnnces, end ell nowssary lahor et my exponws
<br /> :i,itcdlhis .—=�____' _— dryof ..__ '. i �._ .19 '!%
<br /> APPLICANT'S SIGNATUqE —_���/r-�_y'd^Y�C��_�,%1���.�/'��_ _____
<br /> ApplicnnYF Namo �ploasa prinq --J_�'�.r__��_✓�%_—_����'����C __
<br /> �
<br /> APnh:,r.��•, A��:f�os�,n�d Phanr Numboi _ ��G_.5►_—. __ �iS��_�l�.��__
<br /> APPROV D: �'J..�-T.'��—_4LJ_�!.. -_-�F -L-Lt_�
<br /> MUKI / W TERDISTRICT�o„ 'n� � p�`y�};S ��y4'.- �kfc�Cl� � y � �
<br /> � 7 � T� �r�/•F� /O Z� ��ava�^\1' Sf/��w ! , y S�h i�iGc�
<br /> 7S - -f /!i
<br /> .d, . _ . . . -- ---------- - - oa�c
<br />
|