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MUKILTF.O WATER DISTRICT <br />APPUCATION FOR WATF.R <br />i <br />Metcr tiitc: � Scrvice AuJress: � �� f � � � ��' %�' ' ` �' <br />-- -� ----- - � --- - --- -_ ._._. ._--- <br />Numbcr of Units: � <br />Meter will be used (or (check ell thet epply): ._ _'�. Domestic __ __ Irrigetion _____ Pire Service <br />C <br />Acct. No.: _ �i .I � �� _: f <br />L <br />Pire I.ine <br />I herebp npply for welor service enJ ngree �u he govemeJ, in acenrJence wilh Ihc rcsolutions, niles xnd regulntions of Ihe MUKII: fG0 WA71fll <br />hltilltl('T (MWD) prnnining tn watcr servicc, nma nn c�rcnitcr in c17'rct 'fhc undcrsi�!ned ns o���ncr or represcntative o(Ihc hcrcimdesc�ibcd <br />prcmiscs hcrcby egrces ns liillo���.� <br />111 The cnnsuma ngmes In manll, opernlc nnJ mmNnin nt nIi linmx, Iheir pinmFing syslem in cnmph :e wilh Ihe currcnl edtlion nf �hc U�ufnmi 1'lumbm{� <br />CoJe ns il penxms In Ih< preventinn nf canlnminmiix�. nnd prnlcainn from Ihemml expansinn due m n closed syslem Ihel cauld ixwr weh ihe prcsent nr <br />fWurt mslallaGnn nf hnckllmr prcvcnlers on �he cnn+umer's srrvice end�or ni plumhing ficlurcx. <br />UI l�hc cnnsumcr ngrcrs Io inslxll ell bdckllmv prcvrnunn nssemhhce rtqucslcd hy Ihc M WU, anA to mein�ain ihoee M1eckllow prevcmion n��semhGes in g�H�d <br />workmg nrder l hc nsumhlics shnll hc nf e lypc, six enJ mnkc eppnrvcJ h1 Ihe MN'U end Ihe Weshingtnn S�ate IXpenmcN of I Ieehh Authonly 'I�he <br />nasembhes shxll be in�talleJ in ettnrJnnce with ell slnnJords esleM1hsM1rd by Ihe M WU <br />(11 �fhe wnla ma�er xill nnl Fe instellcJ �mUl e wa�u uac eunxy hns hcrn nihmiucJ hy Ih< npphcenl nnd Ihe DisUicls (7nss Cnnnacuon Camml Speci8Gs1 hec <br />d<Icm�ineJ dlhe cuclnmer will nerd �u mslnll n heck0ux pre��em<r nn Ihe ni�tnmer's siAc uf Ihe meler. <br />1� I Ihul Ihe cns� nf nny arlcnsinn af Ihe wmer scrvlce, rcnewui, repincemeN or rcpmr lo ¢nrh miJ scrve Ihe prupeny Jeecrihed shell Ae bomv hy mysdf oi <br />asqFns en uxm•rUl ��f Ihc prcmncr <br />� 5 � Thm nIl pipe+, ��mer niciuuunF dericce nnJ ulhe cunn<cuon apnpmm�l upsticam Gum Ihe meler shell, eller Iheii mstnllnlinn, be enJ ben�me ihe pmpeny nf <br />Ihe MWI �, suh�ecl lu nll ils rcpulatmm penolNn� In uolcr se�v¢c <br />Ib� 7 hnt nllcr nntnllahun, il melcr nr mckr hu� anJ nppun<nnnccs arc bwied �x Jomnged, Ihc owne, wJl Ae hcW rcvponsible end chuged Inr snme <br />� 71 1 h�tl Ihe M WU, tls nllicns enA nEenls, shnll hnve �he rigM nf mgrrsv nnd egress In gn u�xm Ihe prcmius nnd pmprny descriheJ heain for t6a pwpuse nI <br />mepeninn. conncUmg ar Ai�umnecung Ihe srn�ice nr Irn euch nlha purp�ucs ns Ihe scrvrte mny rcyuire h is aisn nnden�a�d Aunng Ihe umr Ihnl any M <br />Ihe wnlcr mnim mny he oW nf srrv¢c M1y rta+nn nf nm enmrFenry or m�prncnnenls nulharved h� Ihe M WU. in mry slrcel ur nlhn locnunn in xhich Ihe}. <br />ma� hm�e he<n laid. Ihe MN'U w�ill nnl he rrqwmA In lumidi �rnhr JunnE Ihe prugrnc uf such mipruvrments lo eny cnnsume whnse wppl� me} Ihu. hr <br />cut nQ an c� hnM1lc fur nny JnmuFcs lirt tls fnilun In An sn <br />IN I �I lun Ihc M WI1 shnll hmc Ihc riRhnn d�xnkc Ihc rmos n� any Iunc hy kcsniuunn, In Icm�vrtenl� disconlmuc Ih� scrvmc In con.unmrs, miJ In mslull thc <br />mcicrl�l la rcFnia lhc wnlcr cnmumeJ 'I Lc M W U shall nnt be hrlA Loblc lin Aanm fc b>' wnle� �n nlha ceuse tsullmp Gom JekcUve plu��abmg ur <br />npphonus innellcJ hy Ihc awncr �x nccupnnl on thc premiscs supphcs wilh aelcr. end Ihc fnn Ihui ngrnls ol Ihc MN'U mny hnvc rospcckd Ihc plumhm�! <br />nnd oppGnnces shall nul be pknJ as n 6mis lirt rtcovery� in <am nf Jnnmge nc nfoicxniJ II Ihe supply of wmer shnll fed nr be mienupuJ hy rcnsun nl <br />ncnArnl. Inw pressme m utlmr cnuse ��hms�kv:r, Ihe MN'U shnll nut Fe LeIJ Lnhh fn� damogn nn� shnll such fnilurc or mlenuplinn lirt xny rcnsunnMe Innc <br />M1e held lo <unsulute n hrcnch nl cnmmcl un Ih< pan u( Ihr A7 W I) m m mry wo� rdmve Ihr cunsumer, uh<Iher I<nunl nr nwner, Gnm pedi�mung Ihc <br />ubliFnUmi nl snch Icmm�'s ui m�ncr's conlmcl 1Vnln shall M10 uscd h} npp6cmn nnl) nn Ihc prcmiscs dcscnAcJ hcmm A ncw epplicnuun shnll Fc IiIrJ <br />shnulA xnmr bc Acslrcd lirt othci prtmi+cs nllhnu�h IucnlcA nn Iw�d JcanFoA hciun <br />�7� l�h�l Ihe M\\'ll recnmmende Inel�Ilolinn nf � prr��urr rt{;nlatfn� vdve. Applfr�nl �rMnnwleARr� Infnrm�llon n 1n IAe rcrnmmendWon �nd <br />�svimr� fnll rrepunx7blllly fnr ImuII1nR ���' fallfnK In im�dl � prcs�ure r�GWulnK vdvr an Ih� x�ler q�elrm In prntrct h fmm hIR� <br />prnaurr. ____ �IN7. <br />U111 �fhr MN7/ ullliin �herq rdrr� �I lhr mvler lo prrrenl w�ter retnrnmR In Ihr DletrkH mdm. Thr �I1PU rrtammrnJe Inalell�llon nf � Iherm�l <br />etp�mlon I�nq In prrvenl aoaelvc pr��.urr build-np c�m�J hc Ihr e�lrr hr�lrr. Appllc�nl�l�tPTwledpr� Infnrm�lian u la Iht rerammend�linn <br />•nd ueumn hdl rexpnnrfhlllry� fnr Imlollink nr faflinK lo Inetall � Ihrrmal e�p�minn I�nM: _ IN'1'. <br />;i-./ � ' „" /.� � , i /� �7 <br />, - , <br />.til9t\9�'PAUIIItPSti �' � �� . I(�IN(I /.it :' __'_BL(x'K_.._ ._.. <br />i'ntccinrenn, Il. � rininnMr <br />—�---- <br />I)WNbI<'tiNAMI� � �'�j�rr/(i�'!'f ;'�{/I�� .�LV I.P.(iAI.U1�3CHll'IIUN .. .'.� . ��T <br />� ncNi u s nnniti ti5 _T,,�•t-f' .��� & c, --- <br />�, , ,,.-���-; / <br />�n��sinrr�iu ___ /' __- _ inu��rrentnissur:nii�'— ------ <br />Ihopmnuasmcluhcuscdtice._____.__'��/" _____ _ INfIIRMA'IIONI.II"I'I'I(R(iIVI:N: <br />til li\9�'I �15'19� <br />I Ir� rlupi•� hnudleJ <br />I h�inrl Imcdlod <br />I ii.vi� i 6nialled I uwrc <br />C71Ali(i�:ti <br />11I ticn�icc inslnllnuon k conneclion chergc <br />121( icncrnl 14icililirc connecuan ohergc <br />� 1 � ( ��liri <br />7olnl mm�wtl rttco�cd xtlh epphnvmn <br />s ���� ; + <br />f 9%� " <br />i <br />f '"'"�-=`�' �;� <br />I I I� I�^ll �I It ti I � H�I � ihai tlus Applicnuun, xl�huugh signcA. shnll nrn hc hinJmg u�m Iha MI IAII:ILU N'A"f h:N UISfHICT unul epprmeJ hy Ihe Dltil RIC I <br />I. Ihr unJrnikned, uenri I��� iepinenlatncl ��I Ihe piu�n•iry� AcccnMrJ nFoce. dn hrreFp muke epp6ceuon fnr inslnllelinn ol n_ �___ 'inch d�mneler wn�er suppl> <br />scn itt �onnauoq. mdudmp nppnnrnnnen. nnJ nll nece�snn Inbyr nl nry etprnxas � �n i j� <br />I I:�IaA Ilus � Ja) id . . .. _. <br />AI'I'I II'�N I ti' Sll iN A I I �HI <br />.1p�uiaml'. NnmclPlrnsc p�in0 .. <br />ApphcnnYs Addrea,C� I'hnnr NumFc� <br />'_L._. <br />� �.._� . . ..__ _-____ <br />�'� _l�_L`r�_. . _'__'___.._ <br />r � <br />�'. ;� ' <br />...� ���1..�.. . , i_.. <br />l�W�tiSI'IINNFI"II�IN(Y�N1H1)I tiIlA1AlAH1'AtitiL55MI�NTOACRfLUN'kL:UUIRLD?� NOy � <br />-I��prnll)rricc SivenflXvia . ___ _. CGSlniliel�� Delc� / _'� l.. � <br />\ � '_ <br />AI'1'RU\'FII: � �\II'KII1611N,\TEHI/ItiIRI("1� .--' <br />H� � 14tiv � ' ' - " IswrJ fly <br />