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" MUKILTF.O WAT'ER DISTNICT
<br />APPLICATION FOR WA7'F.R
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<br />A1etcr Sim: � Scrvice Address: � � �' � " � � '!' % � —
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<br />Numbcr of Units: /
<br />Meter will be used for (check aIl Ihet apply): _✓� Domestic _ _ Irrigation __ _
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<br />-_ ����. No.: _9_�� 1
<br />Fire Service __ __ Fire Line
<br />I herehy npply fnr water xervice und ngrac to he govemed, in ecrnrdmxo wilh the resolulions, rules nnd regula�ions af Ihe MUKII.17:0 WA'll'.It
<br />UItiTRIC'I� (M WD) perinining lo a�u�cr xervice, na��� or heren�er in efkci. The undersigned ns mvner or rcprcsenlative ollhe hercin-descriheJ
<br />prcmises hcrcby ugrtcs as (nllmcs�
<br />( I 1 'Ihe ennsume� eqras Io msloll. upernle mJ mniNnin nl ell limes, Ihcir plumbing syxtem in compliance wilh Ihe airtenl eddion of Ihe Unifarm PlumbmR
<br />CINIe es il petlsins lu Ihe prfvenGnn n(conlnminallMl, end proleQlnn flPnl ihermPl ez(rMsinn duc In P dmed tyllem lhel could [K'cur wilh Ihe praent or
<br />PoWre instel�nunn nf bnckllnw prcvemen nn Ihe cnnsumer's serv�ce endbr nt plumhing firturcs
<br />UI l�he rnreumer ngrees In inctoll nll Fnckilne� prevenu�m esvembGes reyuesled by Ihe M WD, end In meintein Ihme FeckOnw pmvemion usemhlies �n gond
<br />working arder lhe nsstmhhes ahall be nf e type, si�c end meke epproveJ by Ihe M WU enJ Ihe We�hinglon Stele Ikperimem ollleelU AWhonty. 'fhe
<br />nssemM�es shell he inslnlled in ncmrdence wi�h nll slnnde�Jx rsubGshed hy Ihe MWP
<br />I 7� Thr wntcr melat ai�l nui trc InaolleA unul e wnlc� usc survey hes M1cen submilteJ hy Ihc nppGcenl ond Ihe Dislricis C�ov Connecuan Conlrol Speciehs� hes
<br />dcicrmmcA if Ihc cuuunmr w�ill nceJ In mslnll o h�ckllm� prcrenkr un Ihc cuqnmcr's siAe al Ihr mcier.
<br />pt � 'fhnl �he ena ul en} atlenw�n nf Ihe w:iler scivi¢, rcnewnl, repincemenl ur repau lu ren� h enJ scrv< Ih< prnperty descriAeJ ehell he hame hy myself ur
<br />asnpnv ns oHnrq<I ��f Ihc prcnu�c+
<br />131 rnRi nu ����.. �,i�� ������,�����,� dcv¢c� end uthei cunnecuon vympmcm upstrcnm 6nm Ihc mete shnll, nller Iheu �nstellnumi. he enA hecnme Ih< prupeny of
<br />Ihc M W U. sub�rcl In nll il. ttFulnhnm pc�Lunmg to a:nn u�rvrcc
<br />Ibl �Ihm aller mstellaUnn, il mclri nr mcicr har miJ nppuncnnni�cs nrc hunrJ oi JomngcJ, lh<awncr, wdl Ix held respnnsihle enA cher�cd fur snmc
<br />171 Thet the MWU. ns uflittn nnJ ng<nlx. sholl heve Ihe nghl ol ingmss end e@rcsx In gn upan Ihc premises nnJ propeny described herrm fur Ihc pwpom of
<br />mspecunn, connenmE nr Aiscunnectmg Ihe scrvin nr for sudi nlh<r purpnus ns Ihe sen�ice may rcquirc h is elsn unduslnid durmp Ihe umt Ihot eiry uf
<br />Ihe anler mnins mm he nitl af sen�ice by rrncon n! en� emergency or imp�ovemems mtlhnrireJ Fy Ihe MN'U, in eny slrttt or nlha Iixalinn in wnich ihec
<br />mn} hxv< heen imd, lhc MN'I ) will nut bc requircd In fumi�h wntcr during Ihe prngrcss n(sudi impruremems In nny consumrr whuse supply mq Ihus hc
<br />cul nR. �rc bc Iinhlc lin nny AnnmEn lin i1� 6ulurc lu Jo sn
<br />�NI �fhol Ihe MN'U shnll hm�r Ihe iipin lu chnnge Ihe inles nl anp lime A) Necnluuon, lu lempornnh JiscnNinue Ihe srntec In cnnsumers, evd In mx�sll Ihe
<br />melcqs) In ieg�sler IM1c �cmcr cnnwmcA 'Ihc A1 WI I shxll nnl be held ImMa fnr demegc M1y xe1<� nr olhcr ceusc rcsulling Gnm dcfcclive plumFmg nr
<br />apphnnc<s mqalleA hy Ihe nwner nr uccupnN on Ihe prenusex suppha wilh x�eler, end Ihe fect Ihot agems nf ihe MN'U mny hnve inspec�eJ Ih< plumbmg
<br />nnA opp6mices sholl nul he plexJ nx n Fncu fm rccuvaq� in ense af dmm�pe ns nfarcsniJ If Ihe supply af weter shnll fail oi Fe intenupleJ by rcnson af
<br />ncadeN, Ina prcswu m uthcr cnu+c whms�kv��, lhc MW U shnll nnl Fc hAd IinMc fur Jomagcs nur sholl such 6iilure or im<rupuan far nny rcesonaMe Umc
<br />bc hrlJ Iu mnsulutr n hrzoch of mtU�acl nn Ihe pnn of Ihe MWI ) or in nny wey rclmve Ihr mncumer, whelher �anenl ar oHner, fmm perfnrming Ihe
<br />nMignuun nl sudi lennnl'c nr uwnrr's rnNrncl N'mer shxll Me uxd h� npplicwu unly nn Ihv prcnuses JesniM1eJ herem A new epplicauon shell he fileJ
<br />shmJA w�nln hc dcs�rcd lu� nlhcr prcmiscs nllhouFh IocnlcJ on IwJ AcsvficJ hcnin
<br />p1) 'I�h�t Il�r DIN'll r��nmmendn Imtall�tlnn nf a prre�nrr reRal�ling rnhr. Applianl �rknox�kJgea Infarm�llan �e In Ihe rerammend�linn �nd
<br />n�mm� fall r<sponsiFilily fnr Im1a11InR nr GIIinR ��� �n�ldl � prrsvne rrgul�link vdve nn Ihr w�lrr eyelrm In pratcrl ll from hiRh
<br />prte�urr. '� I\7�.
<br />�101 l�he 111\{'ll Wilim cht�k r�h�ee ol Ihr mrlrr In prtvrnt wuer rtlnrninC In Ih� Dielrlcle mdro. 'I�hr �IN'D rrrammrnJ� Insldl�tlon nf � ihrrmd
<br />e�p�nslnn I�nk lo prevrnt rueaeWe preeeurr bu11A-up nu+rJ by Ihe n�ter hrurr. AppBan� �tL oy ItdRe� Infnrm�llun u lo Ihr rerommenJ�llnn
<br />and ���mm� fnll rnpnneibilfq� fnr Im1��IfnR ar failinR In Ineldl a Ihermal rep�minn t�nk. � INT. ,
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<br />1Lv prcnusa an w hr uceA ns n . .__ � �� __ _ ,- � ---�� INPURA1NlON I.f1l7R (iIV[iN: ..�. �—_ � � �
<br />till;�'I�'C 75'I'P. ('IIAH(ifti !�
<br />I)a�clnperinslnllyd � III%erncein.InllmiunRcnnnecunncherge S f�.'/•��'��
<br />Ui.vicl InslnllrJ 121 �ienero� I�acili�ies amneclmn chnrge S_ '�����n' ��
<br />I hanci Iinlnlicd linurr 17� nihcr S
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<br />lolnl nmminl tcccncd �cith epplaxbun S__ _�' �%'-rt ��
<br />IT Iti l MDI(RSIi x �U �hn Ihis Apph<nlinn, nllhuugh signed, shall nol he MnJn�g u�m tl�c MIIAll.11l0 N'Al1iN Ultil NICi uniil epprored by Ihe �)ISIµ1(� I
<br />I. Ihe �mdenignrA. uwn<i I�n u•picunlnGrcl �d Ihr prn�n> dr<cnheJ abnra du heieh� mnAe epphceunn (ur mslallnunn nf e_ /__ -inch Jiemel<r xnlu supply
<br />un i:c i�onncclinn, inchiAmE eppuncnNiccs. unJ nll imcrswq InFpi xl m� cxpcnscs
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