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9504 52ND ST SE LINE 5 2016-01-01 MF Import
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9504 52ND ST SE LINE 5 2016-01-01 MF Import
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Last modified
4/17/2017 7:08:56 PM
Creation date
4/14/2017 3:49:34 PM
Metadata
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Template:
Address Document
Street Name
52ND ST SE
Street Number
9504
Tenant Name
LINE 5
Imported From Microfiche
Yes
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; f; . <br />PRX.�1Si13EEMENT <br />The underalQned hereby r�Quests the City oP Everett to w�.ive <br />the PP�V <br />�� <br />charge on <br />�' S�l'4 �: . �rf <br />hislher water servica at <br />The undersigned <br />represents that the service at said location presently has a PRV <br />in Qood working order and that, in conaideration of waiver of <br />said charge, for the period that undersigned is a water service <br />customer at the above locat.',on, the undersigned agrees: <br />1. To maintain said PRV in good �rorking order; and <br />2. To release the City of Everett from any and all <br />liability arising from increased operating pressures on <br />the ft5 transmisaion line to which the above water <br />service is connected; and <br />3. To indemnify anG hold harmless the City of Everett from <br />any and all claims related to the failure of the PRV <br />installed at the above location. This indemnity is on <br />behalP o! the undersigned, and the undersiened agrees <br />to notify the city of Everett oP any change of <br />ownership of the water service connection at the above <br />location. <br />DATED this _L'__ day of _`����'`�� , 1987. <br />� <br />STATE OF WASHINGTON) <br />ss� <br />COUNTX OF ���� <br />I certify that I know or have satisPactory evidence <br />that /�Ay/�a�Y� .A-• �Ori _ __ signed this <br />instrument and acknoNledged it to be (his, her, their) free <br />and voluntary act for the uses and purposes mention in the <br />instrument. <br />Dated: S�i�1�/`�/����_���— <br />(Seal or Stamp( Signature uf ��� <br />Notary Public: -- <br />Title: _ <br />My commission expires: /��� <br />
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