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�����' "'��:�rRT.�hrii'�:� ^'1-::4�ts,K.�.4f�f �t"f'.� "�''.- "^"�'yr'}^":(Y�1I�M�Nh� <br /> . . �..,� ��� . <br /> � . <br /> MUKiLTEO WATER DISTflICT <br /> SNOHOMISH COUNTV WASHINGTON � <br /> APPLICATION FOR WATER C <br /> Applicalion No. �'� '�V Np 7j-�!,�J/y ` <br /> Meter Size -/'• ' Number ol Units _L__ Accaunt No. G�D—/71ck��,_ � <br /> � I hereby apply lor water serv�ae and agree to be govemed in accordance with Ihe resolutfons, rules and regulatlons ol Ihe � <br /> MUKILTEO WATER DISTFiICT pertaining to water service, now or hereafler in eflect. The undersfgned as owner or � <br /> representative oi the herein-described premises hereby agrees as lollows: �1�1 <br /> (t� Tha�the cost of ony e�ronsion of Iha water�erWee,renewal,raplacement or repair to reach and serve Ihe proporty deecnbod ehell be bome � <br /> by mysetl a ess�gns es owna(s) ol the pramiset. <br /> (2) That nll pipos,water measuriny deNae�end othereonnaelinp equipmant u0��ream irom tha meter ohell,sllar d�eir Inttellerion,be end bemme <br /> the v�openy ol 11»MUKILTEO WATER DiSTRICT,iub�eN ro ed%�re�uletlon�parteininp ro waler�ervka. <br /> (31 That afler inetellalion,it mater o�meto�Eor end apputtente�are buried a damapad,the avner,will ba heM retpontfble end eheryeJ lor seme. <br /> �4) That�heMUKILTEOWATERDISTRICT,ItsoHmon�ntl�penlc,�Mtlhavetheriphtolinpres�endepreutopouponthopremise�endproperty <br /> tlosaibod hoioin tor the purpose ol inapee6m,eanneelinp o�dkonneetlnp Ma terviee w la�uch other purpoees as the wrvice moy require. <br /> It is elso understood drtinp Me dme Mat eity ol Ma webr meinc may ba out ol�erWp by reasp�ol eny emerpaney or imqovemente autfanted <br /> by the DISTRICT,in any sheot or olhar bwoon in whieh they rr�sy hava peen leid,Ihe DISTRICT witl not be raquired lo lumish water dunnq <br /> Ihe propras�ol such Improvemenb ro any rruumer whcie�uppy mey thus be cut oM,a 6e hablo br eny damepet la Ils Ialluro ro do eo. <br /> (5) That Ihe DISTRICT ehell ha�a the ripht to chasqe tlie reta�al any lime by Resokrtbn,ro tamporarily diseanNnua Ihe�ervlee Io�oneumers,end <br /> to insta!I tta mntor(c) to repister 1ha water oonsumad The DISTRICT chall not be held Feble br tlamape by watai or oMm t�uce rewlGnp from <br /> daleoeve plumbinp a epphance�Installea by the owner or xapent on Ihe p�emise��uppliedwNh woter,and the fad thel apante ol the DISTRICT <br /> mey have inspenod Ihe plumbirp and epplianae��hall no;be pbed e�a bad�lor recovery in nee ol demape es eloretdd. II Iha wpply ol <br /> wetcr sholl leil w be inlorrupled by reason ol eeddenl,bw pre�eure a other cauw what�oever,lha DISTRICT thdl not be held liabb Ia domepoe <br /> nor shell eueh leiluro a imertuplion breny reasonabla oma De held lo eonttitute e breaeh ol oontraet on tlie pen ol d�e DISTRICT or in eny way <br /> relreve Ihe concumer,wheMe�tenant a ownor,Irom parlorminp the cblipeGon ol wch IenanY�or owner'�contraq. N/aMr Mell be ucad by <br /> � epplieant only on Iha premieec deecnbad herein. A new eppl'�olh'on ahetl be liled�hwW waler be deslred la oMd prami�u�elthouph Ioealod <br /> � on IaM tlosaibed harein. � <br /> , _(E) Th�� tbs DISTRICT rseomm�nd� Imullnlon ol � prn�u npul�llnp vdv�. Appllwnt �cknoMi�dp�� Infurm�tlon �� to Ih� <br /> rxomm�nd�llon md nwmes lull rs�pond61111y lor Iryh11�F�or ldllnp to In�ldl�prs�wn rpul�tinp vdue on thc wu�r�y�um to <br /> proleet II Irom hlph prn�un. <br /> �v �_(7) Ths DISTRICT utlli:�� ch�ck v�lv�s �t Ih� mNm lo prswnl w�l�r nwrnlnp �o tM DI�tAcb m�in�. Th� DISTRICT rocomm�nd� <br /> Inftdl�Ilonol�thermd�Kpmdont�nklopnv�nl�rbnelwprw�unbulld�upe�u��dEytMw�brM�l�r. Appllc�nu�cNnpwl�dpeu <br /> Inlorm�llon u lo Ih�neomm�nd�tlon�nd uwmN lull rnpondhllly lor In�ullln or I�Ilinp lo Imldl�Ihwmd�tpmdon tmk. <br /> SFRVICE ADDRESg� I fDS I II��� r L.� LOi NO. � BLOCK <br /> — 6 PLAT NAME: '�.. „'n i A 1 �. ;,:_r.� <br /> CITViSTAt621P: ��t.{:_!�� d,�� 1 l..:t `I LEf3AL DESCRIPTION � k + {� �� <br /> OYlNER'SNAME� _�'�-UG !^� � L/._^�... 1"l. - � <br /> OWNER'S ADOqESS. '! � � � :�i � 1,�•J � ' !. , <br /> � C�TY/STATE%ZIP: � � S� I�rU� rv� (If t 5����f� <br /> Tha premisut are to be uced ac e <br /> —Z�� �' � " � '� ' ' ��' � � INFORMATION LETTER-GAVE/SENT: y <br /> � .� CHARGE3: �� I <br /> ;i ��m <br /> (t�Service inetallation 8 connection cherpa S � y ✓ �*"� <br /> �2)Generel Fealitiat conneetwn eharpe t ' � � � r � JI W 2 O � <br /> (3)O�her ��� <br /> Z <br /> To�al amount recerved vdM appliratlon s �3�- � �J MUKILTEO WATER DISiRICT <br /> IT IS UNDERSTOOD thal Ihis App6otion,allhou7n 6igned,thdl nol be bin6rp upon the MUKILTEO WATER DISTRICT unhl eppovad by Iho D�STRICT. <br /> I. Ihe undnisipneA.ownar(a�ePresen�auw)ol the P�W�Y de�be4�bQve.do horeby meke�ppfiesaon br fn�Wlation ol■ --�'i .�� <br /> d�amole�watur�un I serv¢o conneclion,includrp eOW�ance�,�nd dl roeeµsry lebor at my e�pee�at. <br /> Daied this � day of �9 � <br /> APPLICANT'S SIGNATURE. _ �!-- • �� ) , 1�1_ /",J1/,'�.�!j�}� <br /> c <br /> APpl�wnrs Namn(plense pnnfl�. - � bn �l � � �rl �7'✓`� <br /> Applicanfs Address and Phone Number i ../� <br /> APPROVE �1y\ " �`-� <br /> MUKIL TER DISTRICT ✓ J <br /> e� ��"---�—� oab: L ta � _ <br />