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. . . t�,��. ...•,.f+�-rMslnf' ,- r.. �11'yr . . �. „�• �j��� � ���'+ . . . . F Ta <br /> . . .,r. . <br /> MUKILTEO WATER DISTRICT � <br /> SNOHOMISH COUNTY WASHINGTON � <br /> , c <br /> APPLICATION FOR WATER � <br /> C,% No. �/�i ' �.2iti� � <br /> Application No. _ — — <br /> Me�erSize ':/�, Numberolunns /� AccouniNo. _D-�0� �7n�33a- w <br /> I hereby apply for waler service and apree to be govemed In aCCordance wflh 1he resoiutbns, rules and regulations o1 Ihe �yJ <br /> MUKILTEO WATER DISTRICT peAaining to water seMce, now or herealter In elfect. The undersigned as owner or U <br /> represenlative ol the herein•described premises hereby aprees es follows: <br /> (t� Thet Me wst ol eny exloneion ol Ihe wetar�ervke,ronewat,replaoement or repeir lo reeeh end eerva the proparty deecribetl�holl be bome <br /> by myselt a esspns ac owna(�) ol the premi�e�. <br /> (2) Thot all qpes,waler meesunng de�iea�erd other connecGnp eqvipment up�tream Irom Ihs mebr�I�etl,ahor M�air ineGtleNon,be end beaoma <br /> the property ol the MUY,ILTEO WATER DISTRICT,�ub�ea ro�tl M�rapulatlont pertainMp lo wetx�ervke. <br /> (3� Thet al�er installaiion,II motei or meter bua�nd appurlontet ue burled a dameped.the owner,wlll be hald rasyonsfble and eheryed tor eeme. <br /> (4) That the MUKILTEO WATER DISTRICT,its oPocen end egentt.ahaA hew Iha npht ol inprast end epre�e ro po upon tlw pramlce�end p�operly <br /> doscribed horoin lor the purpoee ol lntpectlon,eonn�dinp or 6�eonnecfinp the�ervice a la 5ueh oMm purpo�at es Ihe serviea mey require. � <br /> Il:s elso urdmstood durnp!he tlme thet�rry ol Ihe weMr meM�m�y bs out ol�arvia by ra�son ol erry emarpeney or impovaments Authon=ed <br /> r by the OIST:-0CT,fn sny slreet or olhe�locaeon in which Mey msy he�e been Idd,�he DISTRICT witl not be requirod W lurnich wator durinp <br /> tl�e proprets ol�uah impro�emanh to eny contums�whasa:uppy msy thu�Oe an oH,a be YtCle lor eny damapes la ua laiwre w do w. <br /> (5) Thnt Iha DIS7 RICT thatl heva Ihe npht to chv�pe tlro nM�tl�i�y tims by Rnolulbn,ro temp�xoiy diaeorronun U�e iervke to coneumen,and �. <br /> � toinstehthemeler(c) toreplaerlhewerereon�umed. ThxDISTRICTMeAmtbeheldliablsb�tl�napebywale�orothereeu�eresullirphom �� <br /> r tlalectiveplum6inpaappliance�insUlledtylheamerorxapentontl�eprembne�uppliedwllhWam�,andlhelanMalapenlsoflhoDISTPoCT <br /> may heve inspaded the plumbiip v�d eppfienee�ehell not be pN�Q u�ba�it Im rewvary in ufe ol damape n alore�aid II Ihe wpply ot <br /> wato�enaA lail a be intortupled by raeson ol aedden6 bw preuure aolAer eausa whelaoover,tM DISTRICT�hell not ba held liabb Iw demeget <br /> ' nor ehetl wch leilu�e or intarruption Mr eny reenmebb 6ma De held W mns6Nle a breech ol eontnet on dx pe�of tl�e DISTRICT or In eny way <br /> ratieve Ihe oonwmer,whether tunant a ownar,hom parlorminp Uw ohlip�4on M wM MnenYa m yvnm'�aanVact. W�ror�hall be ueed by <br /> � applieanl only on Ma premfee�dwaibed he�ein. A naw�pplieatlon�hnll be liled�hould wster ba doehed Iw oMer prami�e�a8houph loeated <br /> on Wnd deuribed herein. <br /> n;� ��(e) Th�� tM DISTRICT reeommand� Im1d411on ol � pru�un rpul�tlnp vdv�. Appllunt �dcnowl�dpn Inlorm�lbn u io Ihe <br /> rxommend��bn rnd auumo lull rNpomlbility lor Imullinp or ldlinp�o Imldl�pm�un rpul�tlnp vdw on�h�w���r�y�bm to <br /> .��-1-,` prol�e�I�from hlgh prn�urs. <br /> Mr j7) Tha DISTHICT utill:n eh�cN vdvw�t IM m�br to pnwnl w�l�r nwrnlnp to th� Obtrlat� mdn�. TM DISTRICT nwmm�nd� <br /> Imldl�llon of�Ihnmd�spm��on I�nk lo prw�nl acwdv�prNron bulld�up c�u�W by IM w�lw h��ur.Appllanb�dtrrowl�dqo� <br /> InlmmNlon u lo Ih�neomm�nd�tlon�nd wumN lull n+pondbllly for In�l�lllnp m hlllnp lo Imull�tb�rmd�ip�n�lon 4nk. <br /> SERVICE ADDRESS' ��� PL S�+ ' �� LOT NO. /� BLOCK <br /> PLAT NAME: - �1. II�'�I I��:.. ���%-i 1 .:�'� <br /> CITv�STATFJ2IP: t-�li.i< :..' v_ir' /4i� '- LEGALDESCRIPTION: <br /> OWNER'S NAME: .. �-. . ' - . .� , -'�h T I� J <br /> 1 <br /> OWNER'S ADDRESS. � � ' � ' �' ' ��� <br /> qTYSTATE;21P� . � `T�L., .� i�.�� '/ '� �Y-'7��n 7 . Y � ) <br /> Thc premisoc ere to be uted a�e <br /> ��_�r r `� ( � � ' INFORMATION IETTER-GAVE/3ENT: -�'� <br /> ' � CHAR6ES: D.� <br /> (1�Sa�iee fn�talktan 6 connaction ehdpe { I�- � '• �[�/ <br /> (2)Cr.nerel FadNoe�eonnaelan eherpe { ' � � � � - II IY Il 0 <br /> VVIf G � <br /> (3)Other S <br /> Totet emount ieuived wIM epplin6m s � "=�7� �� " MUKILTEO WATER DISTRICT <br /> IT IS UNDEPSTOOD thal mis Apphcatian,elMouph Npned,�h�tl not Ee bindrp upoa tlw MUKILTEO WATER DISTRICT unM�pprovad by ttre DISTRICT. <br /> I, Ihe underR�gned.owner lor rapre�enteGve)ol Ihe property de�aibed abova,do hereby m�Ae eppGation br fn�ullelbn ol• -ineh <br /> diamoler walur eupply sernce eonneclbn,includrp eppuean�nese,Md al�r1Ya�wry labor�1 my apante�. <br /> Deied thic ,�_ Aey of I19 ��.1 . <br /> APPLICANT'S SIGNATURE� �l ,� � --r-�- i'� '• .LM/`�����y�� <br /> ApplKanfs Name(daase pnmp � �. -�. � �; . '� ,.'�1 <br /> Apohcanfs Addross antl Phorx Numbt�r __�_.� • ' � �' ' �� �^ <br /> APPROVED: ' � . t �vI1 ���� 7'�� <br /> MUKILTE ATER DISTRICT <br /> ey Dae. ��— <br />