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6220 105TH PL SE LINE 5 2016-01-01 MF Import
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105TH PL SE
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LINE 5
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6220 105TH PL SE LINE 5 2016-01-01 MF Import
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Last modified
5/25/2017 2:04:06 PM
Creation date
5/25/2017 2:04:05 PM
Metadata
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Address Document
Street Name
105TH PL SE
Street Number
6220
Tenant Name
LINE 5
Imported From Microfiche
Yes
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PRV A(il3�EMENT <br />The underaianad hereby requests the City oP Everett to Waive <br />the PRV charQe on hie/har water aervice at <br />���_[�����'�s�N�SH_____. The underaiQned <br />repreaente that Lhe aervice at aaid location preaently has a�RV <br />in Qood aorking order and that, in conaiderotion of waiver of <br />aaid charQe, !or the period thet underaianed :s a water servl,ce <br />cuatomer at the above location, tha underaig�ed egrees: <br />1. To maintain said PRV 1n good worklnQ ordar; and <br />2, To raleaae the City oP Everett from any and all <br />1lebility ariaing from increased nperating preasures on <br />the It5 transmiesion line to ahich the above water <br />sarvice !e connected; end <br />3. To indemnify end hold harmlesa the City of Everett Prom <br />any and all claima related to the failure of the PRV <br />inetalled at the above locetion. Thia indemnity is on <br />bel�el! of tha underaigned, nnd the undersigned agrees <br />.to notify the city of Everett oP any change of <br />ownerehip of the wat.er eervice connection at the above <br />locetion. <br />'I DATED this ��� day of <br />STATE OF WASHINUTOM) <br />68� <br />COUNTY OF sNolioMtsx_� <br />,�,,�P?£/`�D� R , i �e� . �,� <br />_� �� �:� i : �l /'l, %1 - <br />- • �� �� ; - <br />!__ <br />,���— '�----- <br />/ <br />I certify that I knoW or have aetisfactory evidence <br />that ��ON H. and CHRISTINE L_ COLE �__ algned thia <br />inetrument end acknowledged it to be (�x�'� their) free <br />and volunteiy act for the ueea and purposea mention in the <br />inatrument. <br />DeLed: ?�8�87 <br />(Seal or Stamp( Signature of � <br />Notary Pub11c� V ---- - <br />T1tle: _Secretary_Y____ <br />My �ommiseion expfrea: ��1/90 ,__ <br />
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