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MUKILTF.O WATF.R DISTRICT <br />APPLICATION FOR WATER <br />MetcrSiie '�u ServiceAddress: a� �%' �"�'� ��' -"��' <br />Numbcrnf Units: 1 <br />�`(vtcter will be used for (checA nll the� apply). v Domcstic 1 rigation _ Fire Service <br />Acct. No.: � p 3�l p <br />Fire Line <br />I hcreh� npplr for weter servicc and eFrco In he gnvamed, in accordena with Iht resolNions, rules end rcguletions of Ihe MUICILTF•.O N'ATLk <br />blSTldl('i (MWD) partaining �o wmer.en•icc. nnw or herte�er in ettect. The undersignad es owner or reprcseme�ive of the hereimdescribed <br />premac� hercb�� agrecs es follnws: <br />( I 1 The ennsumer eR�ees In mslnll, nperele end mmmem ei ell limes, lheu plumbing sysmm m compl�enec wilh Ihe cuttenl ediuon of Ihe Umtortn Plumbmq <br />Cade ss n pertnins In Ihe prrvemmn nlcnntnmineuon, end pmlectinn Gnm lhertnel expensian duc In � cl�ned eystem lhel could acur wilh ihe prcsenl a <br />(u�ure inslelleunn nf heck�nw prtvenkts nn Ihe consumer's scrvice end/or el plumbing GxWrts <br />Q i The consumer egrees In mstell ell beckOnw prtvenuon nvsemblies requcsled hy Ihe M Wb, nnd In memuin those 6eckOnw prcvenuon uumbl¢s in gaod <br />workmg nrder Thc n�scmhlrts shnil bc nf e lypc, six end mekc epprovcd by Iho MRD md thc Wuhington tite�e IXpenmenl of Heellh Authnrity Thc <br />eesembliec shell be mstnlled m eccnrdenec w�lh ell sunderdx es�ahhshed hp Ihe MWD. <br />(� i Tl¢ weler mcler will not be mxlalled umJ n wucr um survey hes becn submitled by Ihe epphcem ead Ihe Duvals Cmss Connec�inn Convol Speciabst hes <br />de�ermmed if Ihe custnmer will neeA In inctn�l n he<kllnx p¢veNer an �he custnmer's side nf ihe meter. <br />��� I ihe� Ihe cusi nf eny extensinn nllhe we�cr s<rv¢a, renewal, repincemenl nr repeh tn mech and serve lhe propen}� desciiheJ shell lx Iwme by mysellor <br />2vsignc es aw�¢rlsl nflhc premisrs <br />151 llmi dl p�pes, wp�cr meevunng dev¢n enA other cnnneclinn eqwpmrnl ups�reem Iram U¢ meler shell. efler Ihar msldleuon, he end M1ecnme Ihe pmpcm nf <br />the MWU, sub�at In ell iLt ¢gulelinns pcneimnE In wnlrr semcc <br />IGI "fhnt elicr insiallnuun, d mae� or mcicr bnx end eppunenenas ere buncd at demegrd, thr ownri, will hc held res�nsihle end cherged fnr semc <br />('� 1Lni Ihe M WD, itc aRmers end e�ents, shsll heve Ihe nght af mg¢xs end ognss to gn upon Ihe premises end pnry�t�y dcecriMd hrrcm far lhe purp��.� � i <br />m�pecunn, connrcimg or diswnnecling Ihe scrvice nr (nr such mher purposes as Iho srn¢c me� reGwrt II ix elso underslond dunng 1he ume Ihe� nm ��� <br />Ihr water mmnx mm� Fe nul nf xorvme by rtnaon o( nm emergene} nr impmvements eulhnriuA hy Ihe M WD. in eny slrttl o� ntl¢i locelinn in wh¢h i�,��.�•, <br />mn� huvc heen leid, lhe MN'U will nrn hc rcquucd ta fiimish we�er Juring ihr pmprcss of such imprm�emeni� in eny consumer whnsc supply mm� ihu i��: <br />nn ull�, ar trc liehle foi eny demngts (nr iu feilurc I�� do sn <br />(N� "I'hn: Ihe M WU shnll hnve Ihe nghno chnnge 1he reies nl nn� lime hy Resoluuon, la mmpnrnnl� dixcanlnme the semee tn ennsumers, nnd In mstnll th� <br />nm�n�a) lu reF�sler Ihe wntrr cnnwmeJ The MIVI � shnll nnt bc hcld 6n61c for Jemage h}� wnkr nr nlher ceuse rtsulUnp fmm Jefeclive plum6mg m <br />npphancvs mstalled hy Ihe ox�mr nr nccupnm on Ihe premises supphes wrth weter, end Ihe !od Ihet egenLs nf tl¢ MN'U mey heve inspecled Ihe phmd��.iq� <br />nnd iy�phm�ca shall nnl he plexd m e hssis for recavery m case nf dnmege ns e(orcseid if lhe supply af weter shsll feil or M1e mlerrupled by rcacon nl <br />ucnAem, low pmsxure or nlhe� couse whelsixver, Ihe MN'P shell nol M helJ lishle for demaFes nnr shell such feilurc ot intem�punn fin eny rcunnuhl�� i rtnc <br />hc hcld In canslnule e hmoch of cunlrecl nn Ihe pen nf Ihe MN'U nr in eny wey relmve Ihe cnnsumer, a�hether Icnent orownet, (mm pednrming tlic <br />nbh�Ealinn n(such IrnnnYs m uuner's enmrecl Wemr shell be uxJ bp epphcent nnly on Ihe piemiscs Gescnbed herem A new� epphceiinn ehell hc filcA <br />shauld wnler bc JesirtA fur ntlmr prtmise� ehhnugh IoceleJ on Innd Acscribed hercm <br />1'q I�L�Uhr MN'll recnmmrnds fn+ullaliun n(w prneure reFul�lln� r�lvr. Applir�nl �cknnMledReR Infnrm�linn �� ta Ihr rernmmrnd�llan onJ <br />nsumes fyMrM�pnnilhllfl�� far fnaldlin{! nr hNinF In Imbll � prn�nn rr{!ul�tinF rdve nn Ihr w�lrr ay�lem In pratrrt 11 frnm hiRh <br />prneurt.l_ 1�'I. <br />11�I Tha �I\{'U ulilim rhrcq rdvrs ol lhc mrler lu prrrrm w�urr returninF In Iha Uieuials m�fns. 'ILe A1N'I� rrcammrnds fneulluinn nf � Ihermd <br />rcpaminn unk In prrvrnl earesi�r prtnnrr build-up tunrd In� Ihr w�tcr h:alrr. Applia��c�nawltJKe� Infnrm�lfnn u lu �ba rernmmcndatiun <br />md auumrs full rc�pnnilb{Iilr (nr ir.�ullin� m failing to Insldl � Ihermd a�p�nainn un4. _ 1� I�. <br />. � : 7 <br />Sllt\"k�l AUUItI[titi.._�: �/� ��4'/'^ ��� �' ���'. _.___ LO"I NO �.7i FILOCV:_ . <br />_.__ ..__. ._--T� . <br />illl�tilAl"Ii'/II � �� � � ��^' PIATNAMI: •_��� ���/. / �r'. -� _ . _ __ <br />' �n n. �,T,, ��) '. q—� G�(f�. . ✓% /!/ .�.'',� /� �.J'! i �/ ��// <br />nNJI(RtitJAA11 � `- '/ � l!.(�ALUL5CNIP710N� .. <br />'I�/��. 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