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<br />MUKILTF.O WATt:R DItiTRIC7'
<br />APPI.IC'ATION FOR WATF:H
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<br />Mcta� tiiic: ' Scrvicc Address. _ � � � .
<br />Numhcr ol Uniis: i
<br />Meter �rill br used for (check nll Ihnl apply): •'' Domeslic _ __ Irtigation ___ Pire Service
<br />Acct.No.:.� �'y� �
<br />Pire Line �
<br />i i�«<n� ����i� fur �cater servicc nnd ngree In bc guvcmcd, in nccurdana wi�h Ihe resulutiona, nilcs nnd reguletions of the MUKII.77[I) N'All'It
<br />UlSlltl(' 1� (M WI )) pennining lo ��+uer service, now ar herealter in elTeci. �Ihe �mdersigneJ ns nw�ner or represemaiive nf the herdn-desr�ribed
<br />premises hen+b)' nEtec� ns fnllm�s.
<br />111 I lm crn�sumr. ngrecl m imtalL ��p�•rme mul mamtnin n� nll umcc, Iheu plumhing system in complience a�ilh Ihe cunenl eJniun of Ihe I lnifrnm Plumhin{�,
<br />CnJe ns it pemm�+ la ihe prcecNwn ol cnmmmm�lmn. nnd prn�ecuon Gom Ihermel exponsinn due in n clnsed syslem �hel cnuld ixcur wilh Ihe pr<cem nr
<br />fiitwe inslallntinn af hnckllma prreenmrs un Ihe �anwmc�'s service enJ/nr et plumhinR Gw�ures
<br />I' 1 'Ihe cnnsumer ugrces Iu inslnll nll hncAllae� prtveminn nsvemhhe� mquesled Fy Ihe M W P, end In mein�ein Nose Aeckllow prcvenunn nssemAhcs m giwd
<br />wnrkmg nrJer "I hc rtssemhGes shell bc of n lype, svc wid mekc epprnvcd by� Ihc �1N�U nnA Ihe \Cxvhinglnn S�ele Ikpetlmenl M I leellh Aulhanly 7hc
<br />nvs<mbhex shn:i hc instnllcA in a¢nrdnnce ailh eil elnndard� eslnhhshcA h� Ihr A1N'U
<br />i' I The wNn mrler wdl nni hv m�lnll<A umil n wemr use surve�� hnc hern wbnuueJ F� Ihe e�iphcnm m�d Ihe Uislricls Crosc Connecunn Canlmi Speciulis� hns
<br />JrlennmcA il ihc o�qnmer ��81 narJ lo mslall n bnck�mc prevenler on Ihe cuvnmerl siAc of Ihe mcler
<br />i.0 Thnt Ihe ca�t nl nnr erlanwn uf Ihc wNci � ervice, rtnew�ul, rcpinceman m repxu In rcnch enJ xenr Ihe pmpen7 JescnAeJ shell M1e Aame hy mpdf or
<br />nssipm uti �nrncrl�l ��f Ihc prcmisn
<br />�� i llmi nll p�pc.. �rnter mexaump Acvi�cs n�id ulher cnnnecunn eympment upslrenm linm Iha meler .Lall. illri Ihcu mslnllnuon. M1e end Fecnme Ihe pinpam nl
<br />Ihe M W I), adqed lu nll II� mkulubnn� perimnmg lo W'ule� s<rvice
<br />un I h;n nilcr m�lnllnlum, i(mrtcr or melcr hnK nnd appuncnonca mc hun<J rn dumngeJ, �hc uwncr, �NII be 6cIA iapnnv�hlc nnJ chugcd inr snmc
<br />i/ i I liat Ihc MWI), tls nlfmo� nnA akenls. shnll hm�e Ihe nglu of mgrcss ond egmss In gn uyon Ihe prtnusec mid prupetly descriheJ heran fnr Ihe pwp��tc ��t
<br />m�pecuun. ennn<dmE o� diaunnecunE Ihe sen��a m fnr such nlher purpnses ns Ihe urv¢e mu> reymre h is elsa unJersl�rod Junng Ihe linie �6m em nl
<br />Ibr watci mam. mny Ire nu1 ��I SC1191C M� RMOII 1�� PII\ [Illff�!fllll� Of I�ll�llP1'f��<011 p111IlOfVCA I1)' IM1f M\I�I), III MY SlffCl Pf (illlfl Ii)Cflil�lp 10 NIIICII lhc\
<br />m:n hnre h<rn Inid. Ihr MN'U ��JI nnl bc mywred �n hmiish water dunnF Ihe pwg¢ss �dsuch inipnn�rmenls In any eo�cumer �vhux supply mn� Ihu. he
<br />nn ull, ut he IinMe �ui nn1 dmm�gec fu� ils fadure In du sn
<br />i N i I L::t Ihc MN'U shnll hnve Ihc n fhl In chnnpe Ihe �mes m nny umc M� Rcsuiuuun, tn Icmpoienly dkcnnlimm Ihc xrvicc tu consmnen, enJ lu ins�xll Ihc
<br />Ina1C1I�1 IO IC4151Cf IM1C \lqll'f [UIISOItICII 16e A1N'U shall noi hc held hnhle fnr Anmxgc hy x�eter nr nlher couse rcsuhing Gom dclaclive plumbmg ur
<br />;q�phnnces miuJleA M �he nwner nr nccupaN nn Ihe premna suppho �a�h xuici. nnd Ihe lec� ihul nFents uf Ih< MN'U me� huve mxpecleJ Ihe plumhm�;
<br />anA npp6nncn shnll nu� hc plcaJ as n hnsis (ur mtnvci} m cxse ul Anmage n+ nfurnniJ Il lhe cupply o! welrr shxll fail nr he mlrnupteJ h� rensnn ul
<br />acadenl, loa p�awm o� olher cxure whm.iwrcr.Ih<MN'U shnll nnl be hciJ Imhle fur OnnmKex nnr shnll sudi Guhirt nr �merrupum� (ur nny rcnxnrmFic limr
<br />hc hclA lu ann+tiunc n hrcnch al cnnlmcl on Ihc pnn ulYhr MN'U m in im� �cn� nhcrr Ihc con�umcr. ahclhcr lenmm �r u�mci. frnm perfmmmK tl¢
<br />n6hFn�hm �d such IcnnnY> m nwnrr's aunnacl \Cnlci slmll he usrA h� xpp6cmn anl� on Ihc p¢mues dcsaihcJ hcttm A ncw epphcnunu shnll hc filcJ
<br />+huulJ ��nler 6e Ai��ueA lur ulher prtmue� nllhouph IncnleA ua ImW decenhtd hUein
<br />p11 I Lel lhr 111N11 rrrommends fn+�ollutinn af � prra�urr rtY.��I�tInR ��ke Applir�nl ecMnnwtrdKes Infnrm�linn u In Ihr rernmmend�tiou �nA
<br />a��un�e� lidl rnpandbllih far InalullinC �rt f�qinK lo Inilxll x prre.nrc regW�tinK nhr nn Ihr wulrr �yelrm In prnl<rt 11 ham hlRh
<br />prnuu'r. IC1.
<br />Illp 1 he �I\5 U Wiliin rhr�k whce �I lh� mrUr �a prr�rn� x�lrr rrturnin� tn Ihr Ill�trlclr meine. 'I�he �IN'D rrcnmmenJs Iminllqtion al � Ihermxl
<br />r�pwndnn lenk lu prtr�m nrrr�hr prrc�nrr hnllA-up awrd L� Ihr e�le� Lnirr. Applinnl �tknuNltJFt� Infarm�lion �e In Ihc rtrommrnduuun
<br />xnJ �sM1unv+ Gdl rr�pnncllrlli�� fnr iml�llin4 nr (�ilinR lo fn��ull a Ihtrmd t�pnndon unM. __ •.._ IR'1�.
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<br />I I I\ I iNUPRti'1�1 H�U Ihai Ihis Applmeuun, nhhuugh siEncJ. shall nm bc hmdmg uMm lha MUAl1:fG0 WA'f1iR UISfRIC! unGl epprnvcJ hy iha Ulti I IUi � I
<br />I. Ihe unJcrsigneJ nxner 1��� represenunicA �dlhr propeny Ar�enFnt ehave. Jn hercM1) mnke eppl¢elinulnr inslalleuon nfa _ /_ anch dmme�e� wnin vuppl�
<br />.en ¢c cunnecUon/� ��IuJmg appunenmica�. nnA nll im�ei�nq InbV� el In) evpenses
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