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� • . . ��;:... �� . . • , . . � . <br /> . . � ri.. . �� - <br /> . ..�f <br /> , - MUKILTEO WATER DISTRICT � <br /> � SNOHOMISH COUNTY WASHINGTON � <br /> IAPPLICATION FOR WATER , <br /> Application No. No. ���'20�� � <br /> I�Aeter Size _ 3����� Number o1 Units _� Accoum No. _D�.�"/7(0 �33� W <br /> I h?reby apply for waler service and agree to be govemed In accordance wNh the resolutions, rules and regulatfons ol ihe � <br /> MUKILTEO WATER DiSTRICT peAaining to water service, now or hereafter in ellect. The undersigned as owner or -C <br /> representative ol ihe herein•described premises hereby agrees as tollows: <br /> (t) Thnt the cost of ony extoncian ol the weter service,renewal,replacemenl or repair to reach and�erve Ihe popony describod ahell bo bome <br /> by mysall or assipns es owner(c) of Me premitet. <br /> (2) That all pipos,water measurinp davice�arW otMrwnneetinp equipmant upqream hom tl�e meler�hetl,aher Iheir instellatlon,ba end hecome . <br /> �he pmporry ol Ihe MUKILTEO WATER DISTRICT,tub�ed to etl 11�repuledan�pertafnMp b weter servioa. ' <br /> (3) Thnt eher inctallation,II moter or meter box and eppurrence�ere buifed a dem�ped,tM ovmx,will be hald�esponslble and cherped lor sama. <br /> (a) That the MUKILTEO WATER DISTRICT,ita oNwn�nd epeNa,chatl have the riph�ol inpress erdeprets ro po upon tlio pramice�and properry <br /> dcsaihod horoin kr Iha purpoxa ol inepec6on,connaelinp or dkonnecenp tha oeMce a for tueh oMa purpoeos ea the servico mny roquire. <br /> II Is also underslood durinp d�e time thal eiry ol Ihe weMr mein�mey be out al�aMca by raeeon ol any emarpeney o�improvements eulMnted <br /> by tha DISTRICT,In any ttreel or olher bceeai in which ihey may heve baen laid,Iha DIgTRICT will not be required to Iumish weter durirq <br /> the proprese ol�ueh impro�emente to any eon�umer wla�a tupply msy Mut be an oN,cr be I�e61e la eny damepee Iw It�lailure lo do so. <br /> (5; Thnl tbe DISTRICT chall have Mie rphl lo thanps Me retet�t my lime by Reaolutbn,to IamDaerily dicwnunue Ne[etvae ro eon'rumcrc,end <br /> roinsWllthometer(�) Ioropi�terlhewamrconcumad. TheDISTRICT�hallrwtbeholdliablelurda�napobywaterorolhaeaucereeullirplrom <br /> deloetive plumbinp a applisnce�in�lalled by!he obner oroeeupant on tha promi�e��uppliedwith wamr,end the lad I�et epanta ol Ihe DISTRICT <br /> mey have inspeded Iha plumbirp and appliance��hatl not be pleW e�e bxci�br recovery In cua ol demape e�aloreceid. Il lhu su�py ol <br /> wntnrahelllailabeinWrtuplodbyreeaonolaaident,bwpnuuroaoMx.esu�ewluboever,IheDISTRICT�hnllnotbelw4.hablelwdamepot <br /> noi shall�uch lailure a interruptwn lorany reasonabk 6me ba held b eon�tltute a bmaeh ol mnlraet on Iha pan ol the DISTRiCT or in eny way� <br /> relieve Ihe consumer,whether tenent a ownur,hum perlortninp tlre oblipetion ol wch IenentY or owner'c cantraG. Wetar�hall be ucad by <br /> epplicanl only on tlie pnmice�dv�crfDad Aerein. A naw�ppliuuon�hsA ba liled�hould water be de�ked la olhar premi�es altMuph laated <br /> ��;r� Ofl�8flf�dB6tf1�hBf0�11. <br /> 8) Ths� �hs DISTRICT recomm�nd� In�tdl�llon ol e pnuun rpultllnp wlv�. Appllwnl �eknoMdps� Inlorm�tlon n� lo ths <br /> rxommand�tlon�nd ruumas lul�napondblllly lor Imldllnp or Ulllnp to le�ull�pn�wn rpul�llnp vUue on Ihe wtler�y�bm to <br /> prot�ci Il lrom hiph prauma. <br /> �a� (7) Th� DISTRICT utlil:�s ehoek v�lvw �t tM m�l�r to pnwnl w�lx nturninp lo tM Dl��deb mdn�. Th� OISTRICT ncomm�nd� <br /> ' In�tellallonol�th�rmd�rpmdonUnktoprw�nle�eNHwpmmnbulldapqu�WbytMw�IwM�1er.AppllcanU�dmoerl�dpu <br /> Inlorm�llon u lo Ihs neomm�nd�llon md n�umN lull rnpondb�lty lo�ImlNlinp or hllinp lo In�ldl�Ih�rmH�xp�ndon unk. <br /> SERVICF. ADDRESS� ����? ��� � J�� SLf/ LOT NO. 7� BLOCK _ <br /> 1 i I� PLAT NAME: '.:%�';•. - ::+•ri�� ��.�oti <br /> — � " �w. � . <br /> CiTViSTATE2IP: .'��+�(i ��'9 G�S'J Ly LEGAL DESCRIPTION: � ✓'/f 1 <br /> OWNER'S NAME:.'`'� ♦. �i i .us_ �.- � /�� ri-,.�_.�`w.4�.�_ <br /> OWNER'S ADDRESS: '"'��/ �!�`� � � <br /> CITY.5TATE%21P: �!s��J ��lt��`� �'�� i (� <br /> Tho premisos ere 10 be ueed ee a <br /> 5� INFORMATION LETTER�GAVE/SENT� <br /> CHARGES: D�*r <br /> ��/. �a..� �CAiL <br /> �1)Sorvice i�stelletlon 6 connoction fierpe S <br /> (2)General Fadlilie�eanraetwn eharpe f ��" � �'� APR � � 1� <br /> (3)Other S <br /> Total emoum reeeived wiM applieeoon f ��G�7 r�/ MUKILTEO WATEA DIl1AICT <br /> IT IS UNDERSTOOD met this Apo�iceuon.althouph clqnad,thatl not be bindrp u�m Iha MUNILTEO WATER DI6TRICT unN appra�ed by the DISTRICT. <br /> I. ihe unrkra�pned, owner(a represanta4Ye)ol Ihe property de�eribad above.do M1eraby m�Fe eppFmtion b�inetall�tbn ol• % �ineh. <br /> tl�amoler wamr tuppl erv�ce eonneawny'nclud�p appurlenanee�,�nd dl ee� I�bor at my aMpentet. <br /> or <br /> Dated mic �� day ol ,1 <br /> APPUGANT'SSIGNATURE����'-/-'''����Q ���� �-�=- / <br /> Apphcem's Name (please pnnll'� i—='�— � / .! `�� ''TI ��� <br /> AOPl�canfs Addc�s nnd Phana Number `"���/ `��1�"//-iIL ,5.�� �' `y � «��✓ <br /> r <br /> APPROVED: '_'"�- �- �r-�'=' �J.: � .%S .��� <br /> MUKILT TE�I DISTRICT <br /> k L � <br /> a, � /�^-�----- oare: /�/'f4 <br />