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6723 123RD AVE SE LINE 5 2016-01-01 MF Import
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123RD AVE SE
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LINE 5
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6723 123RD AVE SE LINE 5 2016-01-01 MF Import
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Last modified
4/27/2017 11:04:18 AM
Creation date
4/27/2017 11:04:17 AM
Metadata
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Address Document
Street Name
123RD AVE SE
Street Number
6723
Tenant Name
LINE 5
Imported From Microfiche
Yes
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TT�e underoigncd hercby requests: <br />OR <br />PRV AGREEMENT <br />The City of Everett install and meintein a pressurc reducing valve (PR� on his/her water <br />ldvlCE at /',� 1 3 11 4 �,(�G ,SA/O Na M�5/� � U/ � <br />md to pay the applicable chergea as stipulated in Ordinence No. 1371-87. <br />Tne City of Everett to ��e�ve the PRV charge on his/her water urvice �t <br />The undersigned represenu that the service at said loc�tion presently hes a PRV in �ood <br />working order and that, in consideration of waiver of said charge, for the period that <br />underaigned is a water service customer at the above location, the undersigned agrees: <br />1. To neintain said PRV in good working order; and <br />2. To release the City of Everett from any and all liabiliry arising from increased <br />operating pressures on the 1!5 transmission line to which the above water service <br />is connecied; end <br />3. To ii�demniCy end hold hnrmless the City of Everett from any and all claims <br />releted to the failure of the PRV installed at the above location. This indemnity is <br />on behnlf of the undersigned, and the undersigned agrees to notify the Ciry of <br />Everett of any change of ownership of. the water service connection at the above <br />locatian.. <br />DATED this � day of �[���� . 19�. <br />� <br />• v, — <br />%'..— �. � � <br />STATE OF WASHINGTOI� <br />ss: <br />COUNTY OF� <br />I certify diat I know or have satisfactury evide ce that �2 Q�rri i2 <br />�ignal this insUumcnt and acw�owledged it tu be his�e /their Gee and voluntary a�K for tfh uses <br />u►d purpoew m,P;E QL'e instrument. <br />�,P� �sswN F�;, ,v'L Dated: / — (� — C! c� <br />o � � <br />` anT,1q y`�' <br />Notary Public: //�j_�/. 1�..�„ . <br />N� �DU9�_'•G � <br />O <br />�i�� a•; •zo�o a� Tide: Ai D�'Nv/) /) iJri'i .�Ii„� <br />p�A �`.: ` <br />-- - hfy commission expires: �22 � , % ,�fX`x'7 <br />�wwarrvm vmn <br />
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