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. . � RECEIVED <br /> � <br /> PRV .'�(3$F:Bt7ENT SEP 23 1987 <br /> UTILITIES DIV. <br /> t <br /> IThe ur�dersigned hereby requests the City of Everett to waive <br /> � the PRV charge on his/her watcr service at <br /> a3y�s _LaB�' Tt �� __M___ The undersigned <br /> ; -- <br /> ; reprasents that the service at said location presently has a PRV <br /> iin eood r+orkine order and that, in conaideration of Naiver of <br /> � said charQe, for the period that underaiQned is a water servlce <br /> Icuatomer at the above looation, the undersigned agrees: <br /> 1 . To maintain said PRV in good aoLking order; and <br /> 2. To release the City of Everett from any and all <br /> liability arieing from increased operating preasures on <br /> the f�5 transmission line to which the above water <br /> I aervice ia connected; and <br /> � 3. To indemnify and hold harmleas the City of Everett Prom <br /> � any and all claims related to the failure of the PRV <br /> i installed at the above location. This indemnity is on <br /> behalP oP the underaigned, and the undersigned egrees <br /> to notiPy the city of Everett oP any chanee of <br /> IoNnerahip oP the water service connection at the above <br /> � location. <br /> i <br /> i DATED thie 9 2/-f-'l dey oP _ , 19B7 . <br /> i ��� {�'�"7 -- <br /> �— —_ <br /> STAT6 OF WASHIN�TON) <br /> . sa: <br /> COUNTY OF <br /> I certify that I know or have satiefactory evidence <br /> I that 's�,/✓�h ��. �A/H5_�Sc�N��C�A .�_. signed this <br /> I lnstrument and acknowledged it to be (his, her, nei ) free <br /> � and voluntary act for the uses and purposea mention in the <br /> I <br /> I inetrument. <br /> i <br /> iI —=f= <br /> Dated : ,_1q87----— <br /> i (Seal or Stamp( Sienature of �� � <br /> � Notary Public� _____��� <br /> I Title: �/�.�. ���__ <br /> i <br /> My commission expires: ��^_^�_�9JlL <br />