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� MUKILTF.O WATF.R DISTRICT <br />APPLICATION FOR WATF.R <br />tite�er Sizc � Scrvice Address: �� �_ __� � � <br />Numbcr of Umts� � � <br />�vtcter will bc used (or (chak all thel apply): __� �__ Domestic ___ Irngation _ <br />_._�._�— ._ Acc1.No: C�.T�L`JG <br />_ Pirc Service __ ___ Piro Line <br />I hcrchy npply Inr waicr tcrvicc �md nprcc to bc gmomed, in occorduncc with Ihe resolulinnt, rules nnd rcgulntinns nf �ha MUKII.TfO R'ATI�:R <br />UItiTRIC'I� (MN'U) pchnining tn �cntcr scrvicc, noa nr hercniter in e1T'ec�. The undcrsi@ncd ns owner ar rcprescntalivc of Ihe hcrcimdescrihcd <br />prcmiscs hcrchy ngrcrs ns fnllnws�. <br />( I � 'fhe cnnsumc� egrca tn mslnll, opero�c enJ meinlmn el nll umes, U¢ir pinmhmg syslem in cnmpliencc wilh Ihc curtcm cdiunn nllhe I lnifo�m Plumhmg <br />l'odc rts il prnnms �u Ihe prtvcmmn n(cnNxminnUnn. nnA prnlccuan Gom Ihrmiel cvpansion due lo e clnsed syslem Ihel cnuld acur wilh Ihe ptescm m <br />fuwrc inslelleuun nf Mackllaw preveNers nn Ihe cnmumci's servicc end�m el plumAing fixlures <br />121 �fhe cansumer egrccs In insleil ell FnckOux prcv�nlinn a�semhl¢s r<qucsleJ hy Ihc MR'U, enJ to meinlein �hme heckOnw prtvcntion ncxcmbl�es in gnoA <br />�cnrking oiJer. l�hc nsvcmhlics shnll hc nf n ly�x, svic enJ mekc epprm�eA M1y Ihc M WU onJ Ihe Washing�on Ste�e Ihpenmem of Ilcell6 Aulhnr0y Thc <br />ns�cmhlics shall bo im�nllcJ in nccaNnncc wllh ell slnndards cslehlrshcd Ay �he M WU <br />� 1� The weler meler will nnl be mstalled unUl e wxlar use survey hex heen suFmiUed hy Ihe applicenl md �he Uislricis Croxe Connmuon Cnmrnl Speciel�sl lin� <br />Actermined if Ihe cuxtnmer wdl necA In insuJl a bnekOnx prevenler an IAc cuclnmer's side af �he meter. <br />141 'Phnt Ihe casl ef any otlension nf ihe wmer scrv¢e, rene��nl, upincemenl m repnir In i<ech end serve ihe propetly desnihed shnll M1e M+me hy myself m <br />essipns ns M1uneqs) al Ihc picmives <br />� 5 i 'I�hn1 sll pipes, antn mrnsurin6 devicc+ nnJ nther cunnecUon ryulpnmm upelrenm Gnm Ihe mcler shnll. e�e Ihen mstnllxUon, he nnA barnne Ihe prnMrty o! <br />Ih< Ml4'11, su6)ccl W nll ��e rcgulnuon� pcnoining la wmn scrvicc <br />I(�I 1 hnl n�c� nulnllnnun, il nielci ni mel<r huv mid npnunenuntts nrc huned m dmm�geJ. Ihe nw�ner, w�ll he h<IJ rr�panvhle nnd charKeJ lin semc <br />�71 �I hal Ihe MW D, iB ullicers nnJ egrnls, shnll hore Ihe nght of hipmxs m�J egruc In gn upnn Ihe premises end prnperty JescriheA herein fnr �he purpu�v nf <br />mspeclinn. cnnnenmg nr eGcmnnenmg Ihe sen�ice or !ur sur.h ather purpotts ne �he +ervl« mny reymrt. II is elsn under:lawl dunng the Um: Ihet eny ul <br />Ihe ��ater mnins mm he nul nf service b� rensun nf on� emerpency nr imprm�emenb nulhonrrd hy �he M WU, in eny xlrttl or nther lucaunn in which Ihcy <br />ncn hnre heen IniJ. Ihe M WU xill nnl hr rcquueJ In f�mish wekr Juring Ihr prnEresc af su<h miprovemems in eny concumci whose supply may ihus hc <br />cul nll�. or Fc hnhle fui nn�� Jnnmpes lin ds lailn¢ In du sn <br />�X i l�hnl Ihe MN'U shnll hnve Ihe ngle lu <hnnge Ihc mles nl nn� lune Fy kesnhnion. lo Icmprnnnl}� Aiscunlinue Ihe service In ennsumers, end lo mvall Ihc <br />nulydsl ln rc�iaer Ihe wmer cnroumeJ �1 he �1N'U �hnll nut bc held linhle fur dmm�ge Fy wnlei m alher ceuse resuhing G�xn d<fecuve plumhmg or <br />xpphances inslnllcA by Ihe owne� m�xcupnnl on lhc p¢nuses supphrs anh weter, end Ihe fncl Ih�t ugenls n(Ihe MWD mey hnve �nspecleJ Ihe plumMng <br />nnd npplinnces tihull nut he plenJ os n Ansis fur rttnven� m rn.�• nf Amm�ge rtc oforesaiJ If Ihe suppir nl waler siull fxil m Irr inlem�pled hy mnson of <br />ncaJ<m. Inx� prcssum ur olher cnuse wlmisiKver, lhe MN'1 ��hnll nn1 be hrld GeMv li�r dnmeKrs nur shall snch lailurt ar inlertuplion frn eny rcesnnnhle unic <br />lu hclJ tu cunslitule e hrrnch nl conlrecl on Ihe pan ol Ihe MWU ar �n mry am timve Ihe cnnsumer. whclher Ienunl nr nwnei. Gum per(urming lhe <br />uhhgetinn nf such Iennnl's nr a�mer's cuNmcl Wnler shnll he ueeJ hy apphcem nnlp on Ihe premisrs deccnheJ haun A nex eppficeuun shell Ae 171eJ <br />shnulJ wnler he Ae�rt<A II+r nlhei prcrohr. ulthuukh IncnieA nn IanJ JucnheJ hercm <br />�7� 'fhnl thr �I\PU rernmmcwis Iml�llatlnn nf n prnvvr re�ul�linR �dvr. Applinm �rknowledkee Informulnn u In Ihe rrammmend�tlnn �nJ <br />m+umn 1'ull resp�nslhllllr for ImmllinK nr fallinC lu Innlnll � preewvr rrknlolinti �dvr un Ihr w�1er ry+lrm lo prntrcl II frnm hlph <br />prn+nrr. �� '- IYI. <br />�Ilq The DIWU nlilirre c6rck rxlvn u� Ihe meler lo pravrm w�kr rrlarnfnK In 1hr Ufatricle malne, 'I�hr MW'D reenmmend� Imtdl�llon af � Ihernul <br />np�minn t�nk In prtrem ncaei�r prtanrr build-up r�u�rd 6y Ihr H�ter hr�irr. Applft�nl FfMp�wledqn infnrm�llnn u In Ihe retmmmtndullon <br />nnd �+�um�s fnll rcepnmibilit� for fn�Idlink or fallhiR In 6nl�ll � Ihrrmd ecp�minn t�nM. L� IN7�. <br />" ' ' n <br />til�lt\'ill�.AUUHfSti .�'. . , . . : � . ' 11)INU . .'_'_�__ _HLO['K. _ _ _ <br />. . ..... �i' . ; !r. .. __.__._.._. <br />('IfY/STA7T211' ._ !,i . , .. . . PIA1 NA�1E . . 1 � _ � /.: ___ __ <br />i e��; _-, .—1 ..`, i /".�. ��.L �„� I.f.(iAl.UftiCRll'IIUN.'___ iI-_._'f . <br />� i\4'Nb:H'S NAMP. r � _- --- . . . <br />UN'Nl-1t'ti 417UItI�Sti � � :, �:1.,� ,. • !.. .. _.. . <br />� �;1 ��1 �,;1i1 � S�L)% /.. __ . - _.�%/ � ��,� <br />IIIY/tiIAIP//❑. ':__ _ _ _'_ . __ III.UGI'GltMll-ItitiIIh:UBY. .� . <br />1 hr p�ennses nre in ha u�ed as e _ ___� . _ . INPORMA�IIUN 1.1'.7TI�R (iIVIiN. __ _ _ _ _ _ _ <br />ti' I�l'1�.1� �.I1'17i. UI�Rci{�S. <br />��� <br />I k�dnprr InslnikA �' (1) ticrvice �nslnllaunn R cnnneclron cherge S <br />r� ���n . <br />Ih.lucilnsUdlaA �21(i<ncrnl�ncililiesumnecfinncharge S . <br />I h.lnci 6nInIkJ I ulwc 1 �I I llha� S <br />—�r7 �i. <br />lmnl mn�nni. �carveJ wilh eppficnunn S__ _.' �� <br />Il Iti 1 iNl il�ltti I� k�U ihm Ihi� Apphcnimn. nl�hnufli sip�mA. shall nrn M hmding uMm �hc Mlll:ll: fG0 Wp1�liR UISI'RICT unlil epproved M1y Ih� U16TR11' I <br />I. the undemgnrd. �ncne� 1��� �epncrnmuvcl ��I Ihe prnpem de�enheA nb�ne. Ju hrrehy mnke apphcelinn fnr inslelleliun of n /. �inCh diamelet wela supph <br />.crri.c runnecuon, mduJnig xppunemumes. nnd nll ncce�snn Iqbu� ai m� rcpem:es <br />I I:i1rJ Ilur �� dm nl �/ . . ' <br />\I'I'I II'ANIti'SIIiNAl1�HP _ _ . ... _ _.. <br />Appli:xnYs NanmlPlcnse pmnl � � .. � . _._... —' _ '. -- _ -_ <br />���q�hcmn's AAdrecti.h Ph�mc Numbrr _ . . _ � � _ _ ' '___ � r. _ ._� i ✓� " � <br />(�R� ititi �'UNNf 191� 14 CI �N fNUI til ��IAfAR1' AtitiF.tiSMI �N f IIAI'AI9 (�\C NI!i)I �IHI?U? __��'�i6 �-�" NQ Q// <br />1�pr ul I)cviac Sim nf Ikvicc C('ti Inilielx ��� Dek ��._�.._ <br />� T <br />APPIt01�l�.Ur�� ,�II'AII:fF011,\7FR IIItiIRI("f . <br />/ . <br />'_ � � ,'.:'. .: _ - . . <br />I�a�o �_ � _ � . IssueJ li� '. <br />