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APPLICATION NQ_ "T U ACCOUNT NO.OaS-,�SOO/�/OC. ^S ,, <br />MUKILTEO WATER DISTRICT <br />/ BNOHOMISH COUNTY, WABHINGTON �� (7 <br />k nonco �in J1 �' � �i �_ <br />APIPLICATIOI�i FOR WATER � <br />Mukiiteo, Washlnqton_�3' c��__, �g� <br />TO THE &UPEPINTENDENT OF THE MUKILTEO WATER DISTRICT: <br />i he�eby apply Ior Iha uee ol watar In accordance with ihe rules and regulalione ol <br />the Mukllleo Waler Dielrid. <br />DurinO Ihe Iime Ihat any �I the water malne may ba taken up hy reaeon ol any Im- <br />provement authorised 6y tha Dielrlcl In or ol any elroe�, toad or olley In whlch they moy <br />have br i laid. Ihe Dletrict will not ba requlred lo lurnleh water during Iha progreee ol <br />euch In.,.rovemenla lo any coneumar whoee eupply may Ihue bo cu1 011, or bo liabla lor <br />any damage !or 11� laflure eo lo do. <br />The awner �hull be W61e for �ny d�megn to the mrvirn mnnecllon. <br />PROPCRTYDESCRIPTION:— �O� JI <br />--�1{�—�er� <br />ADDpF:SS: �aq �- q�I� ��" S UJ <br />Slato eiza oleervice _ Inch <br />i�1�7�_ hae beon racoived wilh Ihie applicohon. <br />ihe prcmleee are lo ba ueed ae a�M!\ �0 �(�n-y� � <br />The owner ol the premleee In _ <br />--�-►�—ia��� ---- <br />j�______ <br />The �tgent ie <br />7'ha Distric� rernmmnndc inslallalion of o preeeuro regula�ing valvo. <br />Appliconl acknowlaciges inlormatlon ae to Iha rarnmmendulion and . <br />Agreee to i�y� proesure regu;e�ingyy� v �' <br />s�,,.,..,1 �crk.t.� S�" /I'fd/,%�—�,�� <br />Declinae lo In t�!( u preseure regulaling valvn <br />Giqned <br />11 It undentood Iha! ell mnnecUon�, IncludinR meter �nd meter box'h�U eemdn tha pmperty of <br />Muklllro Weler Dlelrlcl. <br />, ��. t i :� Slgned_ T ���""`'_ Owner <br />hddreae_�S�P �• ISI0. �"il�r <br />��n.�: � , ���e-,�-s-4$�y�--���N <br />py ---- <br />'�'�:'�,11�.:� P�r,��; �r I�I[- ------- . A9anl <br />Address __. _ _ <br />