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- � ..rr-.-i..��,s�..:a.qf+�•.'�-•..... —�• •---i <br />� . <br />- `' ' MUKILTEO WATER DISTRICT <br />' 1 SNOHOMISH COUNTY WASHINGTON <br />r� APPLICATION FOR WATER <br />Applicalion No. —_--l�� � j �( D <br />Meler Sizo �� � Number oi Units � <br />/ O <br />A <br />�[ / <br />' No. ��'' oZS/'%��/ <br />Account No. – -- <br />I hereby apply lor water service and agree to be governed in accordance wfth the resolutions, rules and regulations oi Ihe <br />MUKILTEO W�TER DISTRICT peAaining to waler service, now or herealter in ellect. Thp undersigned as owner or <br />representative o1 lhe herein-described premises hereby agr�es as lollows: <br />(t) Thnl tha cost ol nny oxtansion ol lho watur sorvico, ronewal, rnplacomunt o� rcpair to roach and sorvo tho pioporry described shnll bo borno <br />by mysoll or assigns ns ownai (s) ol tho promisos. <br />(2) That all pipos, wator maesuring dovicas end othor connoctinp oqulpmonl upslroom Irom iha mo�er shall, eflat thoir InsWlletion, ba ar.d bocomo <br />tl�a proparry ol Iho MUKILTEO WATEii DISTRICT, cub�od �o atl itc ropuletions porteininp to wetor survico. <br />(3) Thnt nllor instnllation, il moter or motur box and eppurtancos ere buried or demagad, iho ownor, will b� haid rosponsi6io and chnrgcd for samo. <br />(4) Tha11hoMUKILTEOWATERDISTRICT,IIsollicorcnndaqontc,shallhnwthoriphtollnprossendegroselagouponlhopromisoFnndproporry <br />describad horoin lor Iho purposo of Inspaction, connocl�ng or diceonnoeUnp tla surv�co or lor euch othnr purposos es Iho Eorvica moy requiro. <br />�I i, nlso undorslood during tha timo Ihn1 any ol tho weter mains mey be out ol service by roason ol eny omorgoncy or improvom�inls nulhorized <br />' Ly tha DISTRIGT, in any slroot or othor locefion in which lhey mey haw hoon laid, iho DISTRICT will not be roqulred to lurni•.h wa�ar during <br />Iho proprnss ol such Improwmonte to nny eoneumer whoso eupply mey Ihue bo eut oll, a be 1ie610 br any damagot inr Its eituro lo do so. <br />(5) Thnt Iho DISTRICT eholl hnw tho right to chanpo tho rete� at eny lime by Rosolution, lo tomporarily disco�tinuo tho sarvico lo caneumers, and <br />to inst:d� tho molor (s) to rogistcr tho wntor consumod. The DISTRICT shall not bo hotd liohb fordemngo by walor or othor cnuso rosulling Irom <br />dalectivo plumbinQ �r npplianws insmlled by tha oyvno� or oawpant on tho prom�soe euppliod with wator, end tho loct Ihat epents of Iho DISTRICT <br />may I�ovn inspocted Iho plumhing nndl�pplinncos shall not 6a ploed es e bnsis lar rocovory in easo ol damngo as aluoeaid. II tho aupply ol <br />wntcr shall Inil or bn intnrruptod by rooson ol ecddonl, low pressurv or olher touso whelsoawr, tho DISTPICT shall nol bo hald liablo lor damages <br />nor sl�all such Iniluro o� inlerruplian lor nny roasonnbb timo bo hold to eanstilulo e 6rooch of contract on tho p:.n ol Ihe DISTRICT ar in eny woy <br />rolinvo th� consumor, whothor lonont or ownar, Irom porlorming the obligalion ol nuch tonanl's or ownor's oonlrad. Wetor shEll bo usod by <br />npplicant only on Iho prnmisus dosaibod horoin. A now applicatlon shall bo filod should wotor bo dosirod lor other promisas ellhough locatod <br />�,I ' � on I�nd doscribod ho�ain. <br />iNt _� (6) Thel �ho UISTRICT reeommends In�tallellon ol � pre�surs repuletinp vaivs. Appilaenl aoknowledpe� Informellon e� lo Ihs <br />� roeommendeilon end e�sumo� lull ras�onelbllily lor In�lallinp or Ialling to In�lall � prassurs repuletinp value on ths walar �yslem lo <br />��- prolecl It Irom high pres�um. <br />iNT �__ (7) The DISTRICT utillze� chock valva� at the meli - lo provenl waler reWminB �o Iha Dblilcb meln�. Tha DISTRICT recommeed� <br />Inlormailon ef� �o the ree m�mendetlon'andr���umss Iulllre,pon�16111y lor�lmt�lllnp ob1�h1�0 �oeln lall • hmPm�l a�p�nslon I�idnke• <br />/ �// �` V��/ ��j ,�- BLOCK _ <br />SERVICE ADDRESS' ��_�,� '' S LOT NO. _ --'-- <br />'/ PLAT NAME: > ''r"" ' / � <br />------�-- ��T �, f1S% •-).%�' `%' 07 LEGAL DESCRIF TI IJ: _�'� / ry� <br />CITYISTAT�.lZIP: TN, " "— S <br />OWNER'SIJAME',��,.GL�� ��� � ` � ���-C�' / �y�` <br />OWN[R'S ADDRESS:/� � ���`y ���//�� "� � ��/ <br />CITY/STATE/ZIP: �� � J�'--�-�� <br />Thn pmmisos n�o lo bo usod os a-- <br />_ �`__��.���i� _ WFORMATION LETfER-GAVE/SENT: ` -- <br />� ' CNARGES: <br />s � �–T/ <br />s //6 7. �v <br />(1) Servico installntion 8 canneclion chargo <br />(2) Canornl Fecili�ios connocUon cho�go <br />PAID <br />NOV � 71995 <br />(3) Olhar i <br />Totnl nmount recoivod with npplication S <br />/3 /7� MUKILTEO WATER DISiRICT <br />I f I S U N DERS TOOD �hat lhis Applicaiion, nllhough signod, ehall nol bo binding upon �ho MUKILTEO WATER DISTRICT until epprovod by �ho OISTR'CT. <br />I, ihn undorsignoA, owncr (or mprosnnlativo) ol tho property dascribad ebovo, do horoby make opptication lor InslallaGon ol e <br />�/ �� i�;n <br />d�amutcr wn�ar su I scrvico co� n�ction, �n �uding nppunonancos, nnd ull nocoscary lobor et my orponsoe. <br />Dnlr.d Ihis �___ da ol �19 >> <br />APPLICANT'S SIGNATURE: '�-r='� J��` L �..� �1.,\ 1'] �- <br />D �9 dL� /t/ c � � � � �� �1 -,,r-��—' <br />AppllcnnCs Namo (pinaso prinil: I, `// s �{�-- � ( (/ �„���� ��� <br />� O <br />Applicant's Address nnd Phona Numbor. _ v/� I�/ ��vv/ <br />APPROVED: �'` �`�`t-�'� � '�" q�� " o <br />M��EO WATER DISTRICT <br />� Date <br />�� G, � - -- y 70 /lf! <br />