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, <br /> PRV AaF3EEMENT <br /> I <br /> I <br /> IThe undersiQned hereby requesta the City of Everett to waive <br /> � the PRV charQe on his/her water service at <br /> �������'`r,�e�E� The underaiened <br /> i <br /> ' repreaents that the service at said location presently has a PRV <br /> Iin eood workine order and that, ln consideration of waiver of <br /> I <br /> � said charge, for the period that underai8ned is a c+ater service <br /> Icuetomer at the above location, the undersigned agrees: <br /> 1 . To maintain said PRV in good working order; and <br /> 2. To release Lhe City of Everett from any and all <br /> liabil�ty arising from increaeed operating preasures on <br /> the �5 transmisaion lino to whlch the above Water <br /> iservice is connected; and <br /> � 3. To indemnify and hold harmlias the City of Everett from <br /> i any and all claims related to the failure of the PRV <br /> Snstalled at thb above location. This indemnity is on <br /> � behalf of the underaigned, and the underaigned aqrees <br /> ' to notiPy the city of Everett of any change of <br /> � ownerBhip of the water service connection at the above <br /> ilocation. <br /> i / <br /> i DATED thie � day of , 1987 <br /> I <br /> I .v`r -- <br /> STATfi OF WASHIN(3TON) <br /> � sa: <br /> COUNTY OF �) <br /> " V <br /> certify that I kn a or have satisfactory evidence <br /> � � ✓ �-'��' .�G���� sienod this <br /> � that _ _1/t��'!u�l�-us— �---- <br /> � instrument and acknowledged it to be (his, her, Lheir) free <br /> Iand voluntary ect for Lhe uaea and purposea mention in Lhe <br /> I inatrument. <br /> I Dated: _ / I '�� � � -- <br /> �---------- <br /> (Seal or Stamp( Signature o2 ��—�� •�-�� �D,�� <br /> INocary Public: —__�'�� __ <br /> ! Title� � -- <br /> i � �j�a8 �_ <br /> � My commisaion expires: <br /> I <br /> I <br /> � <br />