2005, 07-14 App for Water Service8707 E BuckeyeA -Spokan WA99=
PH: 926-4563 FAX: 9238170
APPLICATION FOR WATER SERVICE
The undersigned in applying for water, states: / _
Location of property to be served: 7 3 2 `! L Ly c- ,9L/e—
Legal Description:
Parcel Number:
Interest in property (check one):
( Sole Owner
( ) - Part Owner
(_) Sole Purchaser
(_) - Part Purchaser
( _ ) - Other (specify
Water Use (check one):
( Residential
L oZ
( ) - Commercial - Specify nature of
(_ ) - Other (specify)
Enclosed for security is an advance deposit of $ 1 006/ required pursuant to SECTION V, (I) of the
District Rules and Regulations, to cover the estimated cost of installation which must be prepaid, with the
understanding that if the estimate is not correct it will be adjusted between the District andthe applicant.
Present Tapping Fee will be included in the estimated cost of installation.
Established water allowance:
Billing for water service is done annually through the
Spokane County Treasurer's office. The undersigned will promptly pay all charges and assessments resulting
from Water Service Application and agrees that failure to keep such obligations shall constitute a lien against
the property herein described.
-7/DATE: l v/ V
APP ANT's
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Ap licant's Name/or Firm if Contractor
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Address (including Zi Code
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Telephone (Home / Work