Laserfiche WebLink
ApplicationNo. —_-_.- -_ _ __. <br />Meter Size _ � �� <br />MUKILTEO WATER DISTRICT <br />SNOHOMISH COUNTY WASHINGTON <br />APPLICATION FOR WATER <br />Number ol Units <br />� <br />Account No <br />I hereby apply ior water service and agree to be governed in acco�dance wilh the resolutions, rules and regulations ol ihe <br />MUI:ILTEO WATER DISTRiCT pertainina to water service, now or hereafter in efiect. The undersigned as owner or <br />representative ol Ihe hereimdescribed premises her�by agrees as fotlows: <br />m* <br />(�) iha: Iho cost of nny extonsion ol the weto� sorvice, ronowel, replacament or ropei� to reech end serve the prope/ty descri6ed ehell be 6ome <br />by my6ell o! Besigns oF owncr (s) o! Ihv promi6os. <br />(2) Thot ell pipos, walor maesunng dowces end other conneclinp equlpment upstreem Irom lho meter ahell, etler their Inatalletlan, be end become <br />Ihe proporty of the MUKILTEO WATER DISTRICT, subjoct lo all itc regulntions poMininp to water aervloe. <br />(31 Thet ehor installntion, II moter or meter boz end eppunences ere bunetl or tlamepnC, the owner, wlll be hold responslble end charped lor Rame <br />(<I That the MUHILTEO WATEP DISTFICT, Ita olficers end eponts, �hall he�e tha npht ol ina�een end eprens to po upon the pramiees and property <br />Aosc'ibod herain lor the puryoso ol insDection, connectinp o� AI6LINIfIBCBOA IhB �BMCB OI (Or bUGh OIhB� PUry0606 86 IhB 6Bfnte IfIPy IB(�11i1B <br />It fs also underRmod Aunng the Fme Ihet eny ol Ihe weler mams mey be out of tervice by reason ol eny emerpency or Improve•nenls euthoraed <br />6y the DISTRICT, in eny stmet o• othe� IoceM1on in which they mey hevx been laid. Me DISTRICT wlll not be required to h�.rnieh water durinq <br />tne propress ol such improv9ments to eny cronsumar who�e �u00�Y �Y Ihue he eut o@, or be Gable lor eny damepes lor ile lellure to do �a. <br />(5) Thnt Ihe DISTqICT chell haw� Iho righl to chenpe the reres at eny 6me Dy Rasolution, to lempaedly diaonpnuo Me eerv�-u',o consumere. end <br />to msmll tho mo�or (s) to regiaier the weinr consumed The DISTRICT �hatl not ba held liable ro� tlamepe by water or olhE• cause rosuliinp Irom <br />a�loclivo plumhinp or appliencos inslellad by Iha ownor o� ocwpent on the premiees eupplied wlth water, end U�a leet thet epents of the D IS7RICT <br />may have inspoqed the plumbinp end eppllencos shoU no1 be ylned as e 6asis lor recovery In eeeo ol demege ee eloiosaid II thc supply ot <br />wator shell Inil or be intertupled 6y reeson ol ecddent, low prenaurx o� other ceuso whetsoovor, the DI STRICT shall not be tield lieblo for demepes <br />ner ahell such lailure m inlerruption lor eny roasonable 6me be held M consiitule e breech ol contrect on Ihe pert of Ihe DISTRICI m in eny wny <br />relmve Me consumer, whethor tenent or owner, Irom pnrlorminp the obGpe6on ol tuch tenenC� or owner'c conhecL �Netor shall be ueed by <br />epplicent only on Ihe promisos dosuibed horein A now eppliceuon ehell bo filed ahould waler be doeired lor otlier pre.nitec ellhouph loceted <br />an IanA doscdbed heroin <br />(!) Thet Ihe DISIRICT rscommend� In�tellellon of e pre��ura rspul�tlnp v�lvs. Applleenl �eknowlsdps� Inlorm�llon �� lo Ihs <br />recommendellon and e�sumes lull �eepondbllily lor In�lelllnp or lelllnp lo In�lell � prs�tura repul�tlnp vdus on Ihs watsr �y�tem la <br />p�oiec! It Irom hlgh proeture. <br />(7) The DISTRICT utlllxei chxA valve� et Ihs meler lo prsvant wnar romrnlnp to tha Dl�ulclt mdnt. The OISTRICT rsaommand� <br />In�talletlon ol � thermd eMpendon lenk lo prsvente�ea�dvs prn�w�bulld�up uu�W by ih� w�l�r heeter. Appllunt►�eknowledp�� <br />Inform�tlon �c lo iba recommand�tlon �nd �nums� lull r„pocdbllly lor In�ldllnp or I�Illnp lo In�Ull � th�rm�l exp�ndon unk. <br />SERVICe AD�RESS ��^-_ �� �_�'� �'' •l �� LOT NO. � BLOCK <br />-- Pi.AT NAM't. i � % .'��' �: j �i t' _-i � ri /��i '_ <br />CiTV�STATE2IP: � '�� � y � LEGAL DESCRIPTION. /�'F = " � <br />OWNER'SNAME�. �`�'J<<!•��^��5.:9n�^l_•�� uJL• u.lG <br />OWNER'S ADDRESS. �- Fc T 4«� `I <br />CITY/STATE,'ZIP ':�.rJLt�. �,-/; `'��li�b <br />�IB pfB1111686 !fB (0 bB U6ld 96 ! <br />�� u <br />G <br />'♦ C .-. ��cr�.. <�. <br />INFORMATION LETTER-GAVE�SENT <br />CHARGES. <br />:i?�?� /l ^� <br />(71 Sorvice fnstelle�on 8 connadion charpe S � <br />(21 6enersl Fsalinac connecuon cherpe s /�i�x' n� <br />(3� Olher <br />Tolal emount reeerved with appllcanon <br />S <br />aYt�.i ^ " <br />6 -- <br />�'�i <br />DEC 2 2 20u3 <br />MUKILTEO WAiEF 0lSTRICI <br />IT IS UNDERSTOOD Met thie Apv6cenon, elihouph eipneC, thell not be hindinp upon Ihe MUKILTF.O WATER DISTRICT un61 approved 6y the D�9TRICT. <br />r <br />I, the undenipned. owner (or �apreeonlalive) ol the properry de�eribed ebovc. do hereby make a00hrauon tn� metullauon ol e �y __ �ince <br />dieme�er we�ei �upply earnon wnnecuon, IrKI�nA appurtenences, and ell reeqa�qg lebo• et my e.pensos <br />Da�ee m�s �-�A day o! -- � a. .� <br />APPLICANTS SIGNATURE� � - •"� � �" �-'�`-1�—�•'- __ ___ <br />Appl�canCs Namo (pleaee pdnt)� —'.•t�e +�L � :' u'-�'� _ _ <br />AnPlir,Tofc Aodms� end phone Number ��W; ���� iI v��.��,1..::' �' h : E� � ;`,'.C.�S <br />APPROVED: <br />MUKIL7E�1�lTER DISTRICT <br />Br --���� --- <br />Da�e / ^ /z .' 7<-'-% � <br />,- ° � — <br />al <br />U' <br />� <br />U� <br />