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<br /> �JIUKILTEO WATER DISTqICT D
<br /> SNOHOMISH COUNTY WASHINGTON /„ C
<br /> /- ' 1
<br /> APFLICATIO�J .'-OR WATER �
<br /> App;ication �Jo. — — (��._— ��� No, _1_y -.r ��Z____ �
<br /> Meler Size __% y`______..__ Number ol Units �_ _ Accourn Nc Q�J bC.�Sjj.l),p_�_ �
<br /> : hereby apply lor wafer service and agree to be c�ovemed in accordance with Ihe resolutions, rules and regulations ol ihe C
<br /> FAUKILTFp WATER DISTFiICT pertaining to water Service, now or hereatter in eHect. The undersigned as owner or C
<br /> re,re^crifntive of the herein�desc•ibed premises hereby agrees as lollows �
<br /> � �I..it Ihe cost ol nny e�Iensmr:n!the N•atr.r service,renr.wal, replacnmenl or iepav lo rea[h end snrve Inc prypG(ty describqd shal'be 6ome
<br /> ��} myxclf or n,sions nr owncr,$) ol lho premisCi_ � /�
<br /> �. "6.i�all pipu:,�r.�me•isu`nna di:viv�s nnd olhr.r connoctinp oquipmr.nt uUstroam from�he meln•shri i,n o�Ihair installniion,be nnd bneomo
<br /> 'n pro�;rty of Ihe MUKILTEO WATER DISTRICT,eubjnct Io all Its regulnnons pannining to wo1a� sorv:ce.
<br /> , 'P.,i'nitcr mstnll,�lion,il meter or meto�boz nnA eppuhnnws aro 6unad or damng�d,the ownur,will bc hold respansi6le and chnrgod Ic�same.
<br /> . "I�;u Ihc MUHILTEO VJATER DISTqICT,its ollieors nnd egonts,shell hnvc Ow iight ol ingrosE anA r.gross to po upon tho prr,mises nnd propony
<br /> tlascnbnd hr,rcin lo�Ihn purpose ol'tnspe[non,connotling or diseonnocting Ihe scrvice or lor scch othnr purposos ns Iho se�idce mny require
<br /> r r,nlso undastood dunng Ihn pme Ihat nny ol Me wme�mnins mny be out ol norvice by roason of eny omorpency or improvemonts nuthonled
<br /> !�� the DISTRICT,in nny stroet o�othe�locauon m which Ihey mny hnve 6een laid,the DIS,RICT will not be�eQuiratl ro'umish woier Auring
<br /> P,� progmr.s of such improwments to nny consumar whose supplY mxy Ihus be cut olf,or bo I�nble for nny dnmagos lor its tailure lo do so.
<br /> . � 'I�.nt ttin DISTRICT shnll hnve Me right b chanqe the�ntrs nl nny limo 6y Rnsolutia to Iompornrily dixconlmu�Ihr.snrvieo lo eonsumrrs.and
<br /> t��nslall lhe mulcr(s) Ia rogielw thc N�atr consumnd The plSl RIGT 6hall not 6o hold Im610 lortlmm�gc hy wntar orother causc rosullmg Irom
<br /> r.,.4,ctw^plum hinp or applianrns inslallotl by Rro owner or occupant on Iho promisas supp}af with watnr,onC Ihe tact Ihnt ngents of Ihr.D ISTRI CT
<br /> r•iay havn inspnctcd ihc plumuing nnd nppLancas sh.dl not 6c plond as n hnsis lor rr.covary in caso ol dmm�c�o as nlcresaid II Ihi�supply ol
<br /> w�,icr shnll lail on c�Intnrrupted by ronson ol ncdck+nL low presswa or olhor enuse whnl;oovor,tha DISTRICT sholl not bn held liahle tor danmges
<br /> nr:dmll such lailurv o�iNenuplion Inr ony ronsonable I:me bo held to eonst:INe a breach ol eontruct on thn pan of Iho DISTRICT or in nny wny
<br /> �n'�,�,vn tho consumnr,whvthm Innan!or ownor, �rom pedarming Iho obLgation ol such IonnnPs or owner a contrac� Wnler shnll he usud hy
<br /> :r ,c.in!only on the promisas doscriL•nd heroin A new pppLcntior�bhuli be Ided should Walur Go dusuod lor oiher piamisa;nllhough IocalcA
<br /> C � u I m:!tl,.�...nL�.d h��rum
<br /> . { � � '(G) Th ��he DI:Tf71CT recommende Inntalinllon ol e prouine reguleling velve. Appll�enl xcNnowledges Inlormellon ee lo thr
<br /> ��m.�f�ndnllon nnd eseumes lull responslblllty lorf npinlljpg or lelling Io Inslall e prcaeuro re�uloling velue on Ihe waler ayslem lo
<br /> k ♦ plbypcl II Irom hlgh pressurc. �l� �J y
<br /> . • � f7) The�ISTRICT ulili:es check vnlves at Ihe meler lo prevent woler tolurning lo Ihe Dlsldcls malns. The DISTRICT re[ommends
<br /> - Inslallnliouolalhnrmnlevpnnsloninnkloprevcnlercesslvepre�eurnbidld�upwusedbylhowolerhenler. AppllconlencknQwledges
<br /> Inlormnlion n, la Ihe recommendnlion nnd nssvmos lull rosponslhllly lor Inslalllnp or ldlling lo Inslall e Iherm+� ezpenslon tenk.
<br /> :-RVICE A:Llfii.5; ��II �� � � ^ � -�`�- LOTNO ` � �
<br /> � .•—_ ..-". —.---__ _.___7_� . __ __._ BLOCY, _.__
<br /> T__—
<br /> �
<br /> ------_.. . t PLATNAME r^.i�� �/_.�...; ��
<br /> ��.'iV:'STATEiZI�� �-f�/%� �—^�Q... �J�-�LV LEGAL DESCRIPTION . . .�. . - ---._ . .
<br /> __�-.,, e_' _ _.�_.� —__ .. . ___— _
<br /> �.�^RJER'SNAME. _._L LJ/V.___�_�_-v�LG%C�J�Of / _��H
<br /> — �� _-�
<br /> �?IVNLi75 ADDRESS ---�c%�Ilr� .S�G II%� �'
<br /> ��'t1ATE21P� 1 `<<—��k�� U�A •7y��
<br /> . . � �i�r.es nrr. to be used ns n
<br /> _� iJ.' �c • ..''!- � L:�iJ�-i�J��E_ IYFORMATION LETTER-Gn��; '�,: �.� ------- �
<br /> .
<br /> CHARGES
<br /> �i 1 Sorvlce Instollanon 8 connect�on ch�rge ¢ ___.._ �S� � -,
<br /> �:1 Genurnl FnciliUus connoolion chmge 5 ���� �-_ �
<br /> ��1 oihui y _
<br /> 1�tal umounr recerved wrth e0P6wtwn E '��`I/�, �': J _
<br /> , � �. �', r��nr�� ru�;^�,;�hon.nllhouphygned,shnllnolbebindinguponlheMUKILTEOWATERDIS�HG:Tu�,t. nop�ovucn� tl���'��,-.;i�ICi
<br /> ,�n,yc•si�nen. nwncr (or rr,prc;cnlouwr�ot the propeny dafc:tibqdBtiove,do heroby meke epplicution lor mslallnuur�. o� ; '/4 �r�.i�
<br /> .�-a:te�walnr s pl servia�rnnnrcncn mc nq nppunanan:Es�nnd*II necr.;sxry In6oi at my oMpenso� ' �
<br /> � �n•<i Ilus ��7.�___. A�y.oj. :__'��'' � c, .,lD � .
<br /> �,: r�:.icnnrs si�NnruAE _ _ ���L r �OL� ��ID��F /a J / (�... ���
<br /> Acqi�..�.nnlrName (Plooseprinq -��.�'. ' kY1�iU'(�.� � �
<br /> APpli,an!? A.^.d�r•,•. nnc Pryona Nunt6e. _ ^'j�(D .�+E � I�� � r �� T i j/�J;. . I . '�'� .
<br /> �— ;��g��rv— YAIll
<br /> APPROVED __ _
<br /> MUKILT VATER DISTRICT MAY � 4 �996
<br /> ,,�///���--- _ _ ��:,�� �_�/�
<br /> � MUKILTEU WATER DlSlkibi
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