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. - a <br />MUKILTEO WATER DISTRICT �� r� 6 <br />SNOHOMISH COUNTY WASHINGTON '[ <br />r <br />APPLICATION FOR WATER U <br />_ ApplicationNo. �, No. �RRC1 <br />Meter Size / 4 Number ol Units � Account No. � u� <br />I hereby apply lor water service and agree to be governad in acco•dance wfth the resolutions, rules and regutations ol Ihe <br />MUKILTEO WATER DISTRICT pertaining to water service,� ow or herealter in e4ec1. The undersigned as owner or <br />representative oi ihe herein-described premises hereby agrc�es as follows: <br />(1 � Thet tha cosl of eny oxtenswn ol Iho wemr sorvico, renewol, Jgplecement or repeir to reach end serve the properly deecnbed ehal� bo Eorne <br />by mysolf or essigns ns ownor (s) ol thc prnmisos. <br />(2� Thet all plpas, wator maesuring dohrns and olheiconneclinp equipmant upsheam hom Ihx meta� shell, oRerthnirinetellelion, be end hewme <br />the proporty of tho MUKILtEO WATER �ISTRICT, euhject to all its ropulatians pertaininp lo water service. <br />(3� Thel ehor insNllx6on, II mnlor ar moror bot end eppurtenws ero buried o� demepod. tho owner, will bc hold responsiblo end chnryed for seme. <br />(4) Thet Ihe MUKIITEO WATER DISTRICT, i�s olhcorc end epants, ehell have tho npht nf inpress end eprons ro po upon iho pramises and p�operty <br />descnbed horoin lo� tho purpose af inspaction, eonnoctinp o� dsconrrecfing the tarvica a ler euch ather puryosas as tho service mey r�quira. <br />It is nlso undarstood dunng tho fimo thel eny of Me werer meins mey be out of eervice by reeson of any omerponcy or Improvemenls auMonzad <br />by thc DISTRICT, in eny s'root or other locefion in which �hey mey heve hoen laid, Ihe DISTRICT wilt not be rtaqWred to furnlsh wetor durinp <br />�thn prop�ass ol auch improwments to eny connumar wMse supply may thue 6e eut oN, or 6e lieble lor any dnmeges lor Its lailwe to do to. <br />(.'.) 7hnt Ihe DIS i qIC i shnit hnve tho nght to chenge the reros et eny time by Rosolulion, lo lemporenly discontinuo the tervice lo consumers, end <br />ioinstallthr.molar(s�lorogisrorthuwaterconsumed Tho01STRICTchellnotbeheldliablelordemepebywetororothe�ceuseroBultinglrom <br />dn�octivo plumbing or apphencos inslellc� ty tho avner oro�cupent on Me premieas suppliocf wilh wetar, and Ihe lect thet epents of Ihe DISTRI CT <br />mey Fevn inspoctod tho plumbing end epplience� shell nol 6o plend es a besis lor rocovory in case ol dnmepe ec efmosaid. If Iho supply ol <br />wotor snnll loil or 6o intnrtuplod by rneson of ncddent, low prensu�o oi other ceuso whalsouwr, tlie DISTFICT shell nol be hold lieble lor dnmege� <br />nor shall such IniWrc o� intormplion Ic eny roesonnble timo be hold to constitut� e breach ol conlrect on Me pnrt of ihe DISTRICT or in eny wey <br />�eSeve the consumor, wholhor ronenl or ownor, Irom pedorminp Me ohlipatian ol such tennnf� or owner's wnVed. W�ler thell be usad by <br />applicant only on Ilw promises dosuibod haroin. A new appliee�on ehell be lilad shouM weta be dosimd Ia olher pramitee elihouph IoeateE <br />on land dascribod horoln. <br />n:� ___ (6) Thet ihe DISTRICT reoommend� Indellallon ol � prouur� reguleling velva. Applleanl eeknowladps� Inlormellao u lo ths <br />recommendeilon and ae�umes lull ieaponelblllly lor Inflelllnp or hlllnp lo In�tell � pree�urs repulallnp vdue on Ihe w�lar sy�lsm lo <br />protect It from hlph pre�eure. <br />n:' ___ 7) The DISTRICT u1111aet chetk velve� el lhe meter lo prevenl waler reluminp to Ibe Ul�idets maln�. Ths DISTFICT rowmmsnd� <br />' � In�lellaiionol��hermelerpmdon�enktoprevenleaceulvepranurebulld•upuu�adbylhswtl��h�eter. Appl�eenlawknowledpn <br />Inlormellon �� lo Ihe roeammandellon �nd �uumes lull ta�pon�16111y lor In�tdlinp or t�lllnp lo In�l�ll � Ih�rm�l aYp�n�lon t�nk. <br />SERVICE AD�ESS� �� _9 ^� wr� �" "� �.jOT NO _ I J BLOCK <br />/ <br />-�-- _ PLAT NAME � L-- 1"� � ; I� C ' i ✓ "I( /�I ^ <br />CITYiSTATE/ZIP: \ � � f' �—�,%�� _ LEGAI DESCRIoTION' C <br />OWNER'S NAME�. �—I L�' l�I C r C—'1 L L C � L� � l' ?j <br />OWNER'S ADDRESIS: �`-IC� `J I IO/�'}�� �tyJ� <br />CITV/STATE"ZIP�. `�J;)/I,L��rJL� �-1 �n�J�i <br />Tho premisas era l0 6e used ec a <br />� i <br />TION LETTER-GAVE/SENT: <br />CHARGES�. /� PA� <br />(1) Survico instellehon 8 connodion cherpo S— �n�� �` � O/� <br />(2�GonoralFPdlitiosconnec6oncherpe S— I`1 1I �� V FE� ' j �°�� <br />(3) O�har s _ <br />� � 1�.�.Cj� �e�n(I:TcO l"". _(? n�^_c���r <br />Total emounl received w•itl� apphce6on s � "' " <br />IT IS UNDERSTOOD thetihis Appima6on, elthough sipned, shnll not bo 6indinp upon Ihe MUKILTEO WATER DISTqICT until epprovad by Ihe DISTRICT. <br />� <br />I, the undereigned, uwner (or reprenon�eti�e) ol Ihe property descnbed ebove, do hnreby meka applice6on lo� InstellaGon of a � �� anch <br />dinmaler wale� s p��arvirn conn lio -�nclud�np eppurtenences, end ell neyee} ery 1 or st my expentas. <br />Dated this dey� �,. 1_���1 ✓ �/ c��l��) � <br />—� �-. <br />APPLICANT'S SIGNATURE'�: <br />Applicenfs Name (please pnnl) <br />� Applicenf6 Address pnd Phone Number. <br />APPROVED: L Z— <br />MUKILTEf� ATER DISTRICT <br />B✓,r�' ' /�.r-� DBte�. ^ � .� d <br />