Laserfiche WebLink
.-- <br />Application No. — <br />Meter Size �'� <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTV WASHINGTON <br />APPLICAI'!ON FOR WATER <br />Number o1 Units <br />� �• � � <br />. . � � <br />I hereby apply for water service and agree to be governed in accordance with the resolution3, rules and regulations of the <br />MtIKILTEO WATER DISTRICT pertaining to water service, now or herealter in ellect. The undersigned as owner or <br />representative of ihe herein-described premises hereby agrees as lollows: <br />(1) That the cast af nny oxlansion ol Iho wator sorvice, ronownl, roplacomant or repnir to reach end nervo Ihe proparty descdbed ehall be bome <br />by mysell or essians es ownor (5) of Ihc promisns <br />�2) That ell pipas, waier mF�asurinp dnvicos end o�hor connoc�inp oquipmont upstronm from ihe moror ehell, alte� thel� fnstellelion, he end became <br />tho properry al Iho MUKILTEO WATER DISTRICT, subjnct to ell ftc repuletions portaininp lo waler service. <br />(3) The! elte� instwllnlion, il moler or metxr baM end eppurtances ere 6unad or demepod, Iho owner, will 6e hold reeponsf6le end cherped lor eame. <br />�4� TnettheMUKILTEOWATERDISTRICT,ilaol6co�cendeponrc,challhewtheriphtu(inprossendeprosstopoupon�hopremisesendpiopery <br />desaibod horoin lor thc purpose ol inspoction, connectinp or dtconnacGnp tho eervice or la euch otl�er purposos en tho nervice mey roqui�e. <br />It is nlso underslood dunnp tha lime thel erry o1 Iha weler meins mey be out ol eerviee by reawn ol eny xme�pancy or imp1ovemenls aulhorizad <br />hy tho DISTqICT, in any strnot or olher locahon in which thoy mey I�eoe heen Inid, Ihe DISTRICT will not be required W lumish weter durinp <br />tho propron� ol euch imprown�onls to eny oonsumer whoax wpply mey Muc be cut oH, or ba liable lor any damepes lar Ils feiWre to do so. <br />(S) T�nt the �ISTRICT snnll hnva Mo dght to chanpe Ihe retas el eny time by Resolution, to tempaedly discontlnuo the cervice to coneumers, end <br />tamslallthomolor(s�loiepistorthowetorconsumed TheDISTRICTthellnotbeheldlieblefordemepebyweterorothe�causerasWfinglrom <br />dolacnvc plumhing or npplinnces inetalled by tho ownor or ocapent on me Dramises suppliedwllR weter, end Iho laa thet epnnts ol the D ISTRI CT <br />mny have inspoclod Ihc plumbing end eppllancos shell not be plend ac e besis lo� recovory in case ol damage as eforeseid. Il lhe supply ol <br />w�ror shnll leil or hrt inmmiprod 6y meson ol eccidont, low pressure or otl,er ceuso whelsoover, tlie DISTRICT shell not be hold lieblo lor damepec <br />no� shnll such inilurc oi intermption lor any roesonabla timo 6a hnld to mnstitule e breach ol coMract on the pert ol Ihe DISTRIC' or in eny wey <br />re6nve the mnsumor, whalhor tonent ar ownor, Imm performinp Ihe oblipe6on of such tanenYc ar owner'c eonVecl. Waror thell he uaed by <br />applicanl only on tha pmmis�s doscnhod heroin. A new eppliceuon sheil ba hlod should welrr be dosirad for other promiees ellhouph loceted <br />on land denuibvd Imroin. <br />���- __ (6) Thet the DISTRICT recommend� Imlellellon of � prossuro ragul�llnp velv�. ApplleeN �cknowledpe� Inlormellon u lo Ih� <br />rxommendHlon end as�ume� lull re�pondblll�y lor In�letllnp or I�Illnp to In�lall � pra��u�a repul�llnp vNus on Ihe w�ler �y�bm �o <br />� protxl it Irom hlgh preuure. <br />in� The DISTRICT utlllaes check valve� e� tha mtler lo p�evenl w�ler roturnlnp to Ih� Dltldels mdns. The �ISTRICT reoommanda <br />. In�lallatlon ol � thermel axpen�lon Ienk lo pravsnl eNcae�lve prs�wrs bulld•up qu��d by ih� w�ler heeter. Applleenls �cknowledgs� <br />� Inlormetlon u lo Ibs rsmmmandellon end u�umea tull ro�pond611�y for Imulllnp or felllnp �o In�tell � Ihermd e:pmdon Unk. <br />SERVICE ADDRESS /n��� ����� 'J ''-'J LOT NO � bLOCK <br />CITY/STATE'ZIP� �-��^�' � _ <br />OWNER'S NAME. ��F! �yFI� CC �� <br />OWNER'S ADDFESS� �� �� �����/ '' `� / --y <br />CITYlSTATE2IP. L'%'��/'��!���� (•�,�� <br />Thn pmmisos ero to bo used ec e�— <br />PLAT NAME. I-��C%I/ i�/"/ i�h� �.a/"/.l�!'i <br />LEOAL DESCRIPTION�. �'� `?y3 <br />/�F.ss'/.y� f, H:,,-y �,� <br />LETTER-GAVE/SENT: <br />'1 i...%: <br />CHARGES. pAID <br />.� �, � •'1 �. � <br />(t) Sorvice installalion 8 mnnnaion diarpo 5 '- <br />(2) Generel Fecili�ies conneetion eherge f / /y� ��� �'��� "' ^� '�^^ �� <br />(3�Olher f �I!IT^, i"� <br />,�i���t �..- rr,�i,i_ _. <br />7owl emounl receivod wiU eppliration S <br />I' IF uNDERSTOOD mnt tlm ApplirnUon. el�houph signnd, shell not be hindmg uD� the MUKILTEO WATER DISTRIOT unGl eppored by Ihe DISTFICT. <br />I the untlnrsipnod, ownar (or ropresenleuw) ol Iho p�operty dascnbad ebove, do hereEy meke 6ppNmUon tor instnlle0on ol e -/� -ineh <br />nmmo�ar weta�ypplY sernrn cann n. Iqoludi��ppuhenencei, end ell �� lehor et my erpenaes <br />Daled Ihis 3�__'_ _ Aay � /'�F��JL / __��.• <br />APFLICANT'S SIGNATURE. e <br />� Apphcanls Name (please pnnt) <br />l� <br />Applicenfs Address and Phone Numbar V ,��� � �� � � "�� `, / <br />APPROVED: '-'//���Oq�^�� �'//N )!`•'�37 y�i `�i/:'C�3.� <br />MUKILT�O�'NATER DISTRICT <br />P� / i✓7 "' <br />/ <br />Dete �' ���'�� 5�- <br />�� <br />J <br />�/CJ� <br />vl <br />