|
,�
<br />MUKILTEO WATER DISTRICT
<br />SNOHOMISH COUNTY WASHINGTON
<br />APPLICATION FOR WATER
<br />Application No. __ —__�� _ _______
<br />Meter Size .��'__ _____ Number ol Units _1--
<br />0
<br />�
<br />�
<br />No. ���J'_//----
<br />Account No. _�aQ__.:1�7.G-�J����
<br />I hereby apply tor water service and agree to be govemed in accordance with the resolutions, rules and regulatlons of ihe �
<br />MUKILTFO WAfER DISTRICT pertaining to water service, now or hereafter In eflect. The undersigned as owner or v
<br />repmseniative ol the hereirndescribed premises hereby agrees as lollows: �
<br />�, ) That th•• eost of nny nxlension ol the wntnr snrn,-_r., rr.nrwal, roplaa:men! o� mpnir �o roar,h nnd serve Ihe pro�erry descrihotl sholl b� home �
<br />by irycell or nssit�ns us ownnr (s) o' Ihe p�emises
<br />i� ' Thn: all pipos, wmer mr.nsunng M�vid!s end olhnr eonnectinp oQuipmnnt upstmnm �rom Ihe motm shnll, nhor Ihoir inetallelioq be nnd become C
<br />thr, proparry ol the MUKILTEO WATER DISTFICT, sub�ect to all its regulnuons pohmning la waror sorvicn.
<br />::7; Thai ahar Instnllmion, il metcr or mmer box nnd nppunnnxs rrr buriod or damnged. tho ownor, will bo held �osponsibla end ehnrged to� sann
<br />rq �, '.l;at mn MUKI! TEO WAT[R D!STRICT, ns oflicors end ngonts, sholl haw tlio npht olingrnss nndogross to go upon the promreoE nndproporp�
<br />dr�cnbod hcroin (or iho purposr of inspoction, conrrocling or dlsconnecnng thrt aurvicc or lo� such othm purposos as the sarvicc may roqu�rc
<br />I! �c nir.o undr.rstood dunng ihe time thnt any ol Iho walnr meins may be out ol eervice 6y rooson ol nn� ame�goncy or improvomontr. nuthonnd
<br />u�; !•m DISTRICT, in any slroet or othei lacation in which they mny hnve txren Inid, the OISTRICT wJl not be roquired to furnish water dunn�
<br />nm prngross of such improwmrtnts Io nny cansumer whoen supply mny thus bo cul Mf, o� bc habir, lor any dnmqgAs lo� Its feilurc �o tlo sn
<br />C, 1' n' thu DISTRICT sbnll have thn ne�ht to chengo thn raros at eny timr. 6y Rosolution, lo �rtmuorerdy d�sconunuo tho Rorvice �o consumers and
<br />�r�u�-tn!Ilhr.molAr(s)torogistarthewNereentumad Th��ISTRICTahnllnolDotwldliablofordamngebywalororothereaufiorosulhnglrn�n
<br />Auf r rnvi� pl� imhing or nppLnndrs in slnlled by ihn ownor or ornipnnt on Mw premiso5 supp6ed with Walcr, end Ihc loct Ihnt ap�.!nls 0� lho OIST:7 f;,T
<br />m.�c hmn inspnqed the plumhing nnd npplinnces shnll not W� plend es e hnsis lor recovnry in cnse ol damagr ns nlomseid Il lho supn�y a�
<br />wn i� �r rthnll Inil or 6e Inlanuplqd hy ronson of nccidenl, low proseure or otha cnuso whntsoearr, tho DISTRICT sh oll not 6e hold hnhlr. lor Aama �c;
<br />nor sF�.,�ll xuch failun� or inlerruphon lor nny rc.sonable ume 6u held to consululo e breach ol coNmcl oa Iho pnn ol ihe DISTR!CT or in nny v:,�y
<br />ru�irv.• Ihn ronsumar, whelhm IeneN or rn••nor, Irom peAorming Iho obhpntion ol such lannnCs or ownar'E eontrnct WpICf 6IIDII bG USC�: hy
<br />npp!icanl only on Ihe p•omiso5 dascribod horein A now application shnil Ee lited should water bo dnsirntl lor other premises nllhough bc.ved
<br />� on lan�i dusaihnA heroin
<br />�n^,���(G) Thei �he DISTRIC.T recommende Inetellal!on ol e preuure reauleting velvn. Applleent acNnowled0es Inlormatlon es io ihe
<br />recommendxllon end esaumes lull reepor�'LIIIIy lor Inetolling ar trllinp lo Inelnll a pres�ure reguleling value nn the welar eystem lo
<br />rr �prolect II Irom hiph preenure.
<br />(7) The DISiRICT utilizos check valven oi ihe muler lo prevent wnter returning ro tho Dlaidcts molns. T�e DISTHICT recommends
<br />, • inntnlln!Innolnlhermnlexpnnelonlnnkloprov:ale:coeelvepraenureLulld�upcousedbylhowolerhesler.Appllcanlaecknowledgee
<br />� Inln�mulion es �o �ho mcommendellon end aseumea lull roaponslhllly lor Irolellh�p or Inllinp lo Inslxll e ibermel exppnsion tank
<br />s,i����;,; n:;rnu_„ .'1.U32� -_1Db�1-4-�X1�S5!J.�oTN� _ __�l- - - - e..ocN _
<br />__ . ----- - � - - ---- - - � - - - ---
<br />CITV.'STATE;21P ... ��L�ty,��. . __
<br />OWNFR'SNAME ..!��.�.,,,� � j�,�.. _. --
<br />OWNFR'S AD[1RES9 ___ P-0-- iJc �._ 5�12� .__._C,
<br />C�TV�STATE�2IP� —.�„G.�{.�5%e��_��-�a,j_�Sa.d--.
<br />Thc premises pru to hn uscA ns n j.��y� L_�Srrt�.�—__
<br />U
<br />P�AT NAME ���� Pi.�� _
<br />LLGAI DeSCRIPTION. _______________. .
<br />�!�.�.�c��..�,c..a. --- INFORMAiIONLETTiF7r��;.�t�'�',��t:
<br />CHARGES
<br />' i � Service installouon 6 eonnec�ion chargu 5._. 1`�.y: �' ��
<br />�7i Ganoral Fecilihos conrw:Uon chnrpe 4_���.U�1
<br />f7 Olhor
<br />lotai nmount �ocowod with epPlication
<br />S __
<br />E I U'1 `� S�1L—
<br />I. I� � i'I.: ��� R�:'(ti �: � ria�. tl�r Anpi�;anon, nhhough sipned, shall not bc bindmg upon Ihe MUKILTEO WATER DISiRi�J 1 uni�. , �.��ov,�r. hy Uir ;>!5; ii!CT
<br />I i�n miAurSi�JnaA, ownor (or reprusonL�tiw) ol lhe property disscnbeA nbove, do hemAy maMo opplmntion lo� ip54dln1iun o' n._.__� ��_ �mch
<br />d.,i-numr wnlm euppty servmo connecuon, mdutlmp npP��nenancus anA TII newssary le6or at my o�pen,os
<br />.,,�!�.. Pns —���e'Y_. __ day al _. _ .T'�l� .10 � 1
<br />A���'i P:.AN7'S SIGNA7UFE - �-"'-�- .'(�,t:�Ll�;'v' . �� . _.. �.
<br />�u�:�i .u.ts Nrimr (PleaSe pnn!) — -
<br />.1; i+.. infs Adrnrss And Phonr Numh��•
<br />APPROVED:
<br />IAUKILT��i ATER DISTRICT
<br />, J � ��..�,�-
<br />------ ----
<br />- L�_b_.lie�--S-`�,�---- b53 - a��-'1'
<br />__LG.1.t �c_..�e,..�,�� c�-��S f. ---
<br />: ,,i,• �/�L�j_ — -
<br />7
<br />�
<br />YA1D
<br />MAY 15 1991
<br />MUKILTEU WNTER DISTkICi
<br />
|