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� MUKILTEO WATER DISTAICT a�� <br /> SNOHOMISH COU�'TY WASHINGTON � `\ <br /> APPLICATION FOR WATER �� n y 6�1 v <br /> Application No. � <br /> �_ � 1�� No. �_� � <br /> �� � U S <br /> Me ter Size —__ N u m b e r o l U n i t s _— A c c o u n t N o. — l <br /> I hereby apply for water service and agree to be governed in accordance with the resolutions, rules and regulations ot ihe l <br /> MUV.ILTEO WATER DISTRICT pertaining to water service, now or hereafter in ellect. The undersigned as owner or <br /> representative of lhe herein-described premises hereb��agrees as follows: � <br /> (1) Tnm ihe cost o!any nrtension of Ihe w�Irtr��rvice,ronowol replaxmont or�opair to mach nnd servo the proporty doscribo9 sheil 6e bome <br /> by mysc!1 or nssigns us owno•(s) al the pr �os � <br /> (2) Tnal nll pipos water measurin6 dehces entl. •connocGnp oquipmont upstroam Irom ihe metor shnll,eftor�heir i�stailution,be and become I <br /> Ihe property o'the MJY,ILTEO WATER DISTRw�,subject to ell fts repulmions portaininp to weior sorvice. <br /> (3) TTnt almr inslnll�lion.il metar or mmnr box and nppurtanws e�o bunod or dnmepad,tho ownor,will bo hold rospansi6lo and chargod tor snme. �. <br /> (4) Thu'thnMUKP_TEOWATERDISTRICT,itsol6corenndngonls,shellhawlharigMoling�assandeamsRtogouponthupremisesnndproparty � <br /> doscriboA h�roin lor tlm purposo ol ins0o���an,eonrre�unp or disconrroeting the sorvico or lor eoch othvr purposes es Iho survico may reqwro <br /> II is nlso unAerxtnod during thn timo th�t any o�Me wotor meins mey be out ol service by�nnaon al eny omargancy or improvements outhorized O <br /> by thc DISTRICT,in nny shoat or othor bcalion In w,v,:h Ihey may hew b�on laid,tho DISTRIGT will not be roqwroC to fumish wmur dunna r � <br /> the progmss ol such imp�owmanls lo nny consumor who�e cupply may thuc 6o cut oN,or bo liehlu for eny tlamaaos for its lailum to do co V' <br /> (5) Thn'iho UISTRICT shnll haw Mo nght to r.hnngc Ma rstes et nny time hy Rosolution,to tampore�ily disconunue thc sorvica to consumare,nnd � <br /> IoinstnVthr,motor(s) Iorrtgistorthewnlerconsumod ThoD157RICTshollnot6oholdlin6lolordnmagobywatororolhor��usorosulunglrom <br /> dotective plumbing or nOPlinnrns insullod by the ownor or omipant on Mo promisos suppl�od with wator,end tf ia lacf L9at egnnis ot lhe DISTRI CT <br /> mny hnvn inspoc�od Ihe plumhing nnd npF�lnncos shnll not be plond as a basis lor rocovary In tase ol dnmego ns nfoioseid II Iha supply of <br /> wnmr shnll la:l or be intnrruptad by renson ol ncadonC bw prossura orothar eausn whatsoewr,tho D I STRICT shnli not bo held Im61e lar dnmaG es <br /> nor chall Fuch toilurc or interruplion lor nny ronsonablc timo ba hald Io constiWto e broech al eontrpet on Mw pnrt ol iho DISTRICT or in ony wny <br /> rnLeve Ihe consumor,whathar tonant ar ownnr, Irom pndormmg ihe obligetion ol such lonanfs or owner's contmcl Wntor shnll be usod 6y <br /> nDplicant only on the promisos doscnbed hr.rein A now opplicnuon aheil be tiled should wnlor bv dasirod lo•oUior promisos ul�hough locntod <br /> ' on land doscrihed harmn. <br /> i.;; 6) Thet Ihe DISTRICT reeommend+ In�iollallon ol e pracsure regul�tln8 velve. Appilcent ocknrwledgea Informallon es to ihe <br /> recommendallon end esaume+lull reapon�iblllly lo�Inslalllnp or felllnp to Inslall e prea�ure repuleling valuc on ihe weter ayslem lo <br /> a� prolec111 Irom high pres�ura. <br /> �y; ���j7� Tho DISTRICT u�illzes check velvoa et Ihe meier ta provenl weter m!urning to Iha Dl�ulcb melne. The DISTRICT recommends <br /> Instnllalion ol a Ihermel aipnnalon lenk to ry�evenl e�coselve p�eesure bulld�up enu�ed by Ihe water heeler. Appllcanis ncknowiedpes <br /> � Intormmion es lo Ihe rocommendnilon end aesumaz lull responslbllly lor InsIeIIInQ_or lelllnp lo Inalell e fhermel oxpen�lan lank. <br /> _ �1 <br /> . <br /> I ' J C I G�7 r,�� J �V LOT N0. `, BLOCK <br /> S'cHl9::'r AD'JRr;S _ _ _. - _.____ _—'__.--_-_ �� J.T� -.----- <br /> --- PLAT NAME: ���� I �-� �I �I�I C•I� �J i' -- <br /> � �-- - � <br /> CITYISTATE/ZIP V '�'� \ I � -- LEGAL DESCRIPTIO <br /> OWNER'3 NAME� _ �� ( rj H' J <br /> I lr�j � <br /> ON'NFR'S ACDfiESS� -/"L" � I �� '' '- � <br /> CITY�STATE2IP �'-- �-� .� ��� �� S � - - <br /> 71 I�jl.(_r LLlll( � - <br /> �. , � : <br /> Tha promisos nro�o bo usod as a -�—T <br /> _ ._. INFORMATION LETTER-GAVE/S'eNT _ `J�J C� _ _ <br /> ---- ----___.- ----� - <br /> a <br /> -' CHARGES: i-y^/�Cv <br /> (t)Snrvice instnllation 8 connaction diarpo S — `V � APR 0 3 1998 <br /> (2)Gonoral Fadlilws connor.pon chorgo 5 i� � �_ -- <br /> (�)Olhar S - - <br /> MUKILTEO WATER DISTRICt <br /> ToNI amount rornrvod with applim�on � . I �) / -- <br /> I' I'�l'�:',�I-�i�'�1 c rt;i ttiai 1'n` Apphcat�on,alMough signed,shell not be binAinp upon Ihe MUKILTEU WATER DISTRICT until appmvodby[��e�ISTRICT <br /> I t�u. unA�:rs�an`�� ory�rt�or n�presonLili 1 0l the p oporty doscn6ad ebove.do horoby meke npplim0on for installaGon ol a __v�! _-_ -�nch � <br /> dmmular wmm s�(ial�,servia�eonnoeG ,�gd���PCunoneneos,end nll nea�isnry Inbor al my e�lpnnsas <br /> �iitlLY)I1116 ___✓ d�Y 0� (�� _ ,19 __��> � <br /> - - r o�....,-•_ �!'�-.r'n CJ•-: ^ -'- l r ^ I <br /> APPLICANT'S SIGNATURE� �� ��/4 ��� ��t <br /> �;:phcanCr. Namn (Ptuasc pnnq - " " �/v�� M V S j ��� L `� J__._ <br /> S C U y �, �� �i..., 4� <br /> Apphcanfs Addmss nnC Phonr NumMx __ --- <br /> APPROVED: �`'���•�� ' <. l-Jfi I �.y`)�- ---- <br /> --'------ - - - <br /> ��1UKILT�,� /ATER DISTRICT <br /> ,;�G��Y'f. jC,.--�__ - oe�a _��1��'_ _ <br />