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Application No. !1"✓
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<br />Meter �ize � __._ _
<br />MUKILTEO WATER DISTRICT
<br />SNOHOMISH COUNTv WASHINGTON
<br />APPLICATION FOR WATER
<br />�li0-U � -ob.3
<br />Number ol Units
<br />No. _ _ _���_
<br />Account No. _Q�Q_1�fi.���
<br />� hereby apply for water service and agree to be govemed in accordance with Ihe resoluticns, rules and regulations oi the
<br />MUKII.TEO WATER DISTRICT pertaining to water service, now or hereatter in eflecL The undersigned as owner or
<br />repre;ental ive ol ihe hereimdescribed premises hereby a�rees as iollows:
<br />(�) Tl�,nt Ine cost ol nny exlensmn of the watnr service, rennwnl, re�larnment or repnv to rench end snrve �h� p�operty doserihed 6hell be born�
<br />hy mysell or nssipns as ownrtr (5) ol ihc promises
<br />;7'� ihnt all pipos, wnir.� mansuring dovicas nnd othor connectinp oquipmnnt upstronm Irom tho moler shnll, eftor thoir instelletion, bo nnd becc ie
<br />the properry ol Ihe Ml1KILTEO WATER DISTRICT, rub�oct lo nil i;s rogulntions poMining to womr servir.e.
<br />; 3�� Thn! nhor insmllmion, il metcr or metnr h��r nnA nppunoncos em bunod or Aamngod, Iho a.mrr, will bo hcld ro5ponsibla and chnrgorl br sam^
<br />i4, Tbn! Ihe MUKIL?EO WATEF DISTRICT, its oNixrs end ngonls. shall hnro Iho riphl of ingmss andogross ta go upon �he premisos andpraporry
<br />dnr.-.ritx�d haoin lo� Om pwpose ol Inspxtion, cannechng or dsconnochng Ihc earviw or lor such olho� purposos ns Iho sr.rvicr, mny mquirc
<br />I! �s. nlso undorstood during Ihn firqn thnl any al Ihe wat�r meins may be out of service by raeson al eny eme�gancy or improvemnnts euthnnmd
<br />by ru� DISTRIC'„ in nny sv��ot q� othor locnuon in whir.h Ihny mny hnw boon laid, thn DISTRICT will not be roquimd to tumish wetm d•,n�rg
<br />u�r� progmss a� such Improwmrtnts tn eny consumer whose supply mny thus ho �ut oll, or be liablo for eny camngos lo� tls tnilurc ro dc so
<br />,.� ? bnt Ilm DISTRICT rhall hnw mn ngM ro chonpc thn rntrs et eny time by Rosolulion, to tompornrily discontinuo tho sorvico to consumnr� nnd
<br />io�rstalllhnmutur�s)torrc�istarthewmmconsumed ThADISTR�JTshnllnotboholdliablolordamngahywninrmothorcauserosultinpirom
<br />nr,h•cuveplumhingorqpplianrns �slalloAbylhoownororoccupnntonthopremisnssupplindwithwater,nndthehclthotegontaofthe0lSTRi,7
<br />r»y hive inspedod the plumb�ng nnd nppliancoc shnll not ha plend as e hnris lor rocovery m case ol dmm��o es nlorosnid II iho suppiy o!
<br />wa t�r shnll Inil o� br, intr.rrupled hy ronson ol nccid�mt, low pmssuro or other cnusu whntsoowr, Me 01 STRIC T shnll noI bn hold ImMo lor Aa m.���•,
<br />no� shnll such fniluro o� inlarruplion tor nny ronsonahle time F.r. held lo wnstilule n hmach ol eonlrael on the part af ihn DISTRICI or in nny way
<br />n!h�•ve Ihn wnsumor, whethnr Ien�nt or ownur, Irom perfnrming Iho uhl�pr.tion ol 6uch tonnnYs or owner's eonlraet Wn�er shall be u.oA hy
<br />applicnnl only on fho premisnc de�^��W�d hormn A now opphcnuun shnil be tdad shiould wntr.r 6o dusirnd lor other promisos Nthough located
<br />���� on lanr, dusnibod hnnnn
<br />(6) Thnl Ihe DISTRICT recommende Inatallollon ol e preesure reguleting velve. Appllcent u�Mnowlod�ee Inlormellon ee to the
<br />recommendnllon and ussumes lull responslblllty lor In�lalling or Iellinp to In�tall e preseure reputeling velue an Iha wetar tyalem lo
<br />,, ��/ prolecl II Irom hl�h presaure,
<br />(7� The DISTRICT uulizoe che�.�k vulves el Iha mele� to prevanl walar relurninp lo Iho D�eldcts melns. The DISTRICT recommends
<br />� Instnlhulonolelhermnloapnneloninnklopr�venlexceselveproaeurebulld•upcou�edbylhewelerhe�ter.Applleanlnecknowledgca
<br />' Inlormo0on na to the rer,ommundnlinn end eaeumrts lull responsl611ty lor Inalallinp or lelling lo Inslal� a thermnl expeneion tenk.
<br />i /� �G/�� ! 7
<br />'? �l\'I,;F ADDR; SS _a O� S� . �L�� �i.�" � � L07 NO _� �„2 ___ ___— BLOCK _ _ __
<br />_ _ �� //j��
<br />__ ___.. _. PLAT NAME ���YL�^'�! _ —��___
<br />,/ � � � _p_ _
<br />_ _.. ____. _
<br />c'.i'v; ;TATE:ZIn. _6;�,.1�.C�'-I.r �A ! I��,� LEGAL DESCRIFTIOW _� __?� _____ _.
<br />�V:FJ�R'S NAME �� L UrN �F- Si✓J/?-N
<br />'ri7N: R'S ADJRC55 �P' GCn --- - ! �� � --- —..
<br />�:�-v srarE zi� L f������'1� NS w� , ri�.�� _
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<br />1��� �,•a�n�sas nrr to bo �-u__so��d ppas n�� /� __� � /�� _",._
<br />1'L'� J �� . . _ __ VJFORMATION LETTER-PAVNSnN"
<br />CNARGE� /�
<br />�� 1 Scrvicc �nsiul�alion 6 connec0on ehorgc b_- /! �
<br />�:�i Gomm�l Fnal�uos conn�r:uon charge $ ____9�y
<br />�:�, o�nor
<br />intal amounl rocerved wiM epplicalion
<br />/��
<br />PAID
<br />FEB 2 2 1991
<br />5 —�f%_.��.11l�__MUKILTEP WATER DISTRICT
<br />'� L;�i.�i�;Y.�.il�piatr���Apt��n.�non.nithoughsipnnA.shnllnotAobmdingupon�heMUKILTEOWATFRDISTRICTununpp�ovndbvtt�cDl",Tf1R:T
<br />>
<br />'',. untkn6igned ownu! �o• mpresunl.mc�.V of pir pioperly M�s; rihutl ntwVa, fb hereby meko OPPLeupen I,r �n�.1,Jvii�:n� o' a �� ��. inr� '•
<br />,... -.rler wnlor up dy scrviu� tonnereor �ua}�:� nppunanun;es. anA nll noeassary lebor el my ovponr.es
<br />!.it�.�;: I4is _� �— day ol L�,ra�FL•Z�-••- J�J Q'� '—
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<br />A:�p..I��AN7�S ;I;;I:AIJ;l: �i�"` .. •7� � v 7. -_.—__—______-
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<br />Ai:n<i.rt.N�m�-lPl�..i« ointl ���..� _//''_� � �!".'_„�_'—_ _.--_.
<br />Ar:'hcan'? AA�rr•• p�id Pnnm� N�.inin�n�,�v l% � ��
<br />APNROVED <,u�i--lfy���—�i ir�, A� %5��� G> �j— %li.��
<br />� _ ---- t _ __ ,
<br />'11UKILTEO W/ATER DISTRICT
<br />.. ///,[�/ [- ' "_ - . �I.II„ ���Z1!-�...._ _.
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