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r ...�'"__'�9rTr�.►�'•.v:r,y..�� ..• .. •+...�, pR.J .. _ . . . . . . . ,. <br /> MUKILTEO WATER DISTRICT <br /> SNOHOMISH COUNTY WASHINGTON � <br /> APPLICATION FOR WATER C <br /> Application No. u / No. '��' _+�'�1 i� � <br /> Meter Size �/�% Number ol UnNs __ � Account No. �0'J7lc�3.38' S <br /> I hereby apply lor water service and agree to be govemed in accordance wBh the resolutions, rules and regulatfons of the °�' <br /> MUKILTEO WATER DISTRICT peAaining lo water serviCe, now or hereafter In elfed. The undersigned as owner or W <br /> represenlative ol Ihe herein-described premises hereby agrees as follows: UJ <br /> (1) That tl�o cost ol any eitension of IM wete��ervke,renewal,rep4cemenl a�repair fo reaeh and ea�ve tha propery described shall be boma � <br /> ty mysell o�ecsipns ac owner(c) ol Iha premfte�. <br /> (2) That nll pipos,water measurinp devian and othe�ounnectlnp puipnsnt up�tream hom Ma malar�hetl,eher Iheir Inetelleuon,be antl become <br /> ihe property ol the MUKILTEO WATER DISTRICT,�ubJact b eA fl�repuletlon�.�pertafninp ro wator�ervice, <br /> (3) That aher Instnllalion,if moter ar meter boK and eppurtenca�ere buried w dem�ped,the amer,will ba held ra�pon�ibb�nd charged lor ceme. <br /> (4) Thet Me MUKILTEO WATER DISTRICT,ite oN�cen�nd�pent�,slup ha�e Ihe ripht ol inpre��and apre�e lo po upon die premiees and propeny <br /> doraibed horoin lor Ihe pu�pose ol incpeeuon,eonnaqinp or 6comnae6np tha�erviee a la tueh oMe�purposas a�Iho servico may roquire. <br /> It i�also understooi dunng Ihe Iime Iha!any ol Me we0er m�int mey bs al ol�aMw by rea�on ol eny omerponcy a improvements authorized <br /> by Ihn DISTRICT,in any street or olher bcalian In which tl�ey�ryy hs�e yean�aid,Iha DISTRICT will not be raquked ro fumich wa�m durinp <br /> the oroprees ol�veh improoemenb M any eoneumar who�s�upply m�y Mu�be eut oM,a W liable lor eny demapoe lor IIs lailure Io do co. <br /> (5) Thot the DISTRfL'T ahell heve tlie rfpht lo chenpe Ihe ralat n eny time by Retolulbn,to lemparerily di�eontinue Uio�ervira to eontumnrq nnJ <br /> tuiustatlthomeler�c) Iorepi�te�Ihewatercomumsd. TheDISTRICTthaNrqtbeheMliWlelordamayebywemrorotharcaucorewttinpirom <br /> dofecuve plumbmp orappliance�muelled by the owner orocapent on Ma prembet euppliedwiM�warer,end Iho lan U�at epanta ol lhe DISTqICT <br /> may heve Inepected Iha plumbinp end epplianee��hetl not l+e plesd u�be�is kr recovery In u�e ol damepa�s elore�eid. II tha euppy ol <br /> watar�haA Iail or be intortupted by roeson ol�aidenl,bw pretturs aother esu�e wheboeve�,d�e DIS fFICT�hali nol l�e heW liablo fa demepos <br /> na shall�uch Ieilure or interruption breny rvaamebb uma ba�eld b eontliprte a braseh ol contrael nn Iha pert�I p�e DISTRICT or in eny wey <br /> re'ieve Ihe mnwmar,whed�er tenant a ownar,Irom perMrminp IM oblipedon ol weh tenanY�or ownar's eonheU. Water�hell be usnd by <br /> epplieaM only on Ihe premien�de�aiDed herein. A new applieation thetl 6e libd�hould water be deefred la oMx premitee eNlwugh IowteA <br /> on land deurlbed herein. <br /> �r,r J (0) Th�t th� DISTRICT roeomm�nd� In�tdl�llon of � pnuu» rpul�linp vtiv�. Appliemt �dtnowNdp�s Inlorm��bn n le IM <br /> rseomm�ndUbn�nd uwma�full rospondblllly Im Imtdlinp or fdllnp to In�ldl�prnwn rpul�llnp vdw on Ih�w�ln�y�lam lo <br /> probct I�Ir�m Alph prneu�u. <br /> �vr _(7) Th� DISTRICT will:n cA�ek vdvn �t tM m��x lo pnwnl wtln ntwnlnp Io tbs Dbldcb mdn�. Th� DISTR�CT naomm�nd� <br /> In�Utl�llon ol�Ih�rmd��p�ndon unk to prw�nl�ra�dw prw�un bulld�up e�u��d by IM wNa hnl�r.Applic�nb�cknowlsdp�� <br /> Inlormtllon��lo Ih�r�comm�rd�lion md�s�umw lull rNponNbllly for In�tdllnp or ldllap to Intl�ll�th�rmd eRp�ndon Unk. <br /> SERVICE ADDRESS� I � L�� I 1 I lh !�( ���.. � LOT NO. _ � BLOCK <br /> ` PLAT NAME: ��JL (�!)'�11�I AJ'/ <br /> CITY/STATEIZIP: �'-ti��.l� 1'U� `I f��/ LEOAL UESCRIPTION: E"1Cl 1+., j <br /> OWNER'S NAME: _=%---L'� i�!�I�1 � 1.%i� <br /> OWNERS ADDRESS: _ ` J I� ST�1- I /. 'l ' � � ��� <br /> CITV�STATElZIP: � � `�"'7 i�J', � //-� �I 1,' �S'!�/L) <br /> Tho premises ara to hq uced�c e ' - <br /> ����� ( �' INFORMATION IETTER�GAVE/SENT: _—��_ <br /> J <br /> ' CHARGES' �� <br /> (t)Sarvice in�tellatbn 6 connedion fiarpa f � tli, �' <br /> � (2)General FadliGee eonneelion eh�rye � � � L � �'�� J� G Q � <br /> �a�ana� s UKILiEO WATER DISTRICI <br /> Totel emount recelved wiM appliatlm f - � '�v� '`� � <br /> IT IS UNDERSTOOD Ihal lhis Apphcaiion,almouph cipned,�he%nM be bindrq upon Iha MUKILTEO WATEF DISTRICT unW�ppro�ed by tM DISTRICT. I <br /> I.the undnnlpnad.ownar(a rapre�entauvo)ol the property de�crihed ebove.do hereb�malw eppRation Mr imtalletion ol■ I , <br /> dmmoler waler�uppl y nervic�wnnectan,indudnp eppurtenance�.md dl nsce�sey Iebor et my expen�ee. �—�i� <br /> Daled thic tlay of ,�p <br /> APPUCANT'S SIGNATURE: ' � I } � � ,�',��..� •�� <br /> AppltcenfsNar(pleasepnnl�� -- � — ! r •'i � J <br /> AppiKanfs Adda�s eM Phone Number. ` � I i - . t N�= _(�. 1.J „ �✓ <br /> �� <br /> APPROVED: <br /> MUKILTE TER DISTRICT <br /> B� _ oer: Zi <br /> � <br />