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APPLICATION NO.�_ _ � r� �� <br />-_ ACCOUNT NO.Q�S'�,�DO/�,e <br />"""� MUKILTEO WATER DISTRICT <br />fNOHOMI6H COUNTV, WABHINp70N <br />q5h ; <br />IAPPLICATION FOR WATER i <br />TO THE SUpEHINTENDENT OF kTBE UKILTEO�WATE p� p�CT: '�B� I <br />ths MuklltecYWete'i D(elAcj° um ol wnler in accordance wilh Ihe rule� and regulallone ol � <br />P*ove�menQaulhorRedhby he DleMct n�'or ol�any elreel,br od o� ajeyY�n e,°h�ch theyYm y � <br />n ch mprovemonls�lo anry'c n,e'umer whoceueupply muoy' hue ba� ulrollohberllable�lor <br />any damago Ior Ile Ialluro eo io do. , <br />The own�r �hdl be Wble fot �ny d�maga lo Ihe rcrWm connectlon, <br />PROPCRTY DF.SCRIPTiON:��7- � <br />----�Qy-�L—_l.�a.r�cle„ � <br />ADOflE55: <br />Siate ei:e ol cervice __,�,�1�. _ ��ch <br />�--J-1•7�[LJ—hae baen reeeived with Ihla applicution. <br />The promiaee nro lo bo ueed ae a�,{�_x.(A n,�,� <br />n <br />iM ownar ol lha promleee le �JJ]Z_�_����� � <br />The apent i!i_ � � <br />APPl�anl�ncknowlodgee inf��mati n ao�to Ihour common'da�i n�'and . <br />Agreee to I�a1pM.0 proeeure reoulalie., ��I,.. .. <br />Declines lo i � <br />+W a preseuro roguloling valve <br />Signed _ <br />It la underelncM Ihet �II rnnnecNom, Includinµ meter end meter box ihdi remdn lhr proper(y of <br />Muk111to.Wetcr�Uietrlc�, <br />4 Q (� f '� , � ' Signed �G .u� � j� /�/ <br />. �- Q,i �_—. �/ / l� �� LCao.�� . Owner <br />A ddrees ��J ��%� �,�e I I"N.l.r <br />'lll..11 !'UiiL'f f'Ic <br />C,a�„cu,o ss 9ga9 3� 8 � <br />�Y ---------- <br />0 . Agen <br />Address_____ _ <br />