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<br />' APPlication No. ------!�`�
<br />Meter Size
<br />MUKILTEO WATER DISTRICT
<br />SNC�HOMISH COUNTY WASHINGTCIN
<br />APPLICATION FOR WATER
<br />✓
<br />No ___9� �1.3__
<br />____ Numbcr of Jnits __�--- Account No. ��-/7yb��
<br />I hereby apply for water service and agree to be governed in accordance wilh ihe resolulions, rules and regulations ol ihe
<br />MUKILTEQ WATER DISTRICT pertaining to water service, novi or hereafter in eflect. The undersigned as owner or
<br />reprnsent�(ive of Ihe herein-described premises hereby agrees as lollows:
<br />'(t; ThN !no mst of nny r.zlnnsion ol Ihe wnler service. mnowal, replaxment or rr.pnir to roach nnd eerve Ihe propClTy doseri6ad shall he bome
<br />by mysr.lf o� nssigns ns ownm (5) ol Mn premisos �
<br />(T, Thnt oll pipos, wntm mensunng dovices ond olher connocting oquipmont upslroam trom U�e motar shall, altnr their insta!lation, 6o ar,d br.wme
<br />thc pr�perry ol Ihc MUKIL7E0 WATER DISTRICT, suAjad �o ell IIs rogulntians portnining lo welor sorvico.
<br />ia) 7hat niter instillnfion, it mntar ar molar bux nnd nppunancos nrr, buriixl o� damngnd. ihe ov+ner, Nill be hnid rnsponsibin end chargod lor semn
<br />in� Tnn! Iho MUKILTEO WATER DISTRICT, its o�Ltors ena ngnnts, sholl hnw Iho rightol mgmss nnAogr�ss la po upon �hc premisos nndproper,y
<br />doccribnd horein lor thc purpose af inspoetion wnrwaing or diseonnoeting iho sorvieo or lor such oihor purposos as Ihe eonice may ronune
<br />I� �: nlso undorstood dunng tho 6mo ihat eny al the walnr mams mey 6e oul ot snrvice 6y reeson ol eoy emoigoncy or improvoments eulhnrizr�C
<br />hy fau DISTRICT, in uny streel or other loc��ion in which thoy may hnv� Men I�,id. Me DISTRICT will nol bo rnquirod to furnish wnle�r tl�.n�ng
<br />tnr nrogross o! such improvomonts to nny consumxr whose supply mny thus ba c�t ofl, or 6o hnAlo for eny dnmepos for its lailure to do sc
<br />i9 �, Thn� Rm DISTRICT shnil hnve the ric�hl to change Iho inlos ntAny I�me hy ResoluUon, Io tempnrnrity discontinue Ihe sorvice to tonsumers nnd
<br />iov�,stnllthnmoror(s)Iore9i,Imthewalr,rcnnsumod ThaDISTRICTshnllnothoholdhohlofordmm�pobywatororothe�causerosul6ngirnm
<br />r.u�r cevr. ?lumhing or appliances mseilled ny Ilm owno� or occupnnl on Iho promisos euppLotl wi�h wator, enA tho lact that ngonis o� Ihe DISTRI CT
<br />ma�� I�,nve inFpoclnd tho plumhing nnA npphnnces shnll not bu plvnd es n hnsis lor racovory in case ol dmm�gn ns nlaosxid II th� supply ol
<br />w W��r shnll lail or hr. inlerrupled by �anson ol qccidonl, low prassura or othor cnusn whntsoovnr, the 01 STRIC T sholl not 6n hold lir.hle lor dnmages
<br />nr r.linll Fuch inilure or intr.rruplion lo� any �oasonable umo be held to wnslilute n brench ol wnVact on tho pan ol thn DISTRICT or in nny wny
<br />rchovr• thrt consumor, whethur lonnnl o� ownur, fram perbrming �hn obligntion ol 6uch tnnnnl's o� ownor's centmct Wnler shall ho usod hy
<br />� npplicnN only on Ihe promisr.r, desaibod hurein A new opplicnuon shall bn)iled should w�tar be dosirnd lor o�harpromisos elihough ;ncaled
<br />��'� on pmd dusc�ihod,fiFri:in
<br />r;� ��6j Thul the DIST.iICT reaommEndn Instoqalfon ol e proeeure rogulating velve. Appllcent acknowledgee Inlormellon ee to Ihe
<br />. recommendnllan und eseumen lull res�• �ilhlllty lor Ine�elling o� fulling lo Ins�etl e presaure regululing value on Ihe wetar syetem lo
<br />w� �7 � prolecl II Irnm high prefsurn.
<br />/ (7) The DISTRiCT uillizes check volves e� ihe meter lo prevent welor relurninB io the Dlsv:cts melne. The DISTRICT recommands
<br />• inelallotlon ol o Ihermol expannlon Innk to provenl excevelve preeeu�e bulid-up ceusad by Iha walor hentca Applicente qcknowled{�ee
<br />� Inlarmallon on b Iho r nfman n ion o se4mes � ill reepanel6111y lor Inslalling or Inlllnp lo Inntull � thermal ekpmslon lank.
<br />t�a�,���°-lu�1t, �4. �.v,j
<br />tif;ia.��:t;•ADDHESP, G+������O�L^1��'�"lYi�_ LOTNO ___�__.�� __. ELOCK ._ .
<br />�--- ---IQ'�ITD'��C~�.�"'��..�. PLATNAME �1r��}isQ<�— �cr�
<br />CiIY: ;TAfEIZ�P. _ �C.r C�' . �., .___._ LEGAL DESCRIPTION _ ___ _ _..
<br />n�,NWGR'S NAME� ��'�t��.tL'Y1 �. ��.m�,.-�v}____.—_ __. ' -
<br />owrar.a�s no�aess ���'x,t—� 2. -�
<br />crr' ;TATEZIP. __�(,��_4�SL�1S� "1� ZS� _ . —. . . ..
<br />Ii��. �„mmses mc lo hc used ns a �. � •v�,�+_. _ _ .. . _..._._..
<br />.'�t���S�,—u` .-----� INFORMAJION LETTFR-GdVE/SEP:T �' ��
<br />CHARGES
<br />_�,
<br />! � I Servicu instullalion 8 connection charga E--�G.�-�=.�i.�____ ._
<br />I. � Ganorel Fnalilia5 cor.nar.uon chargo S—l�y�-�' �=---
<br />(?i OIFor
<br />E _
<br />iata� amount rocorvod with eppLcation E — < <� � �'} � �' � — �
<br />� , �� H-;'J.�;�mnil',�sApph�..ilmn,elthouphsignod,shallnot6obindingupon�hoMUKILTEOWATERDIS1RiCTunn�enp�ovu�ibplrm;llSiqlCT
<br />� r�� � unM�rsignvd, ownv (or ropresenl�tiw) al Iho propeny cfoscribod above. do hemhy moko applicetion lor installauon of e_=�_ u�cr-
<br />.� ,iniulm walur supply sornrn connuouon, ipaluding anpunonances, and all nocoasnry Inbor el my eKpensee
<br />;�.�t�,Clhis _1'�.�_ dayol .�.___ __ 'in C�_— �
<br />�� � ,
<br />/.�'�`JCANT'SSIGNATURE .tL'�"�/'"��%-�2tq_
<br />t�: i i�,-anfs Namc (plaase prinll _--SC���_S�1_5..�1dY.b._ _—
<br />'` 1 i
<br />�.. ; �..•. A;I<"�.a• ard Phane Numl-..�• .._ �y�_.V��"F --��?� ���� ZiJZ�.
<br />A P P RO V ED : �� -�-L-�i� �->yS -----� S- �-
<br />MUKIL A ER DISTRICT
<br />� 7 I ��^-�-� _
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<br />__ _ o.ne
<br />1_2�/ _
<br />PAID
<br />APR 151991
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<br />NUKILTEU WATER DISTRICI
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