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<br />Water Metering Agreement - Page 5 of 7 <br /> <br />SIGNATURE PAGE: <br />FOR THE COUNTY <br /> <br /> <br />__________________________________ <br />Kittitas County Public Health Department <br /> <br /> <br />Dated: _____________________ <br /> <br /> <br />STATE OF WASHINGTON ) <br /> ) ss. <br />COUNTY OF KITTITAS ) <br /> <br /> I certify that I know or have satisfactory evidence that ___________________________ is the <br />person who appeared before me, and said person acknowledged that he/she signed this instrument and <br />acknowledged it to be his/her free and voluntary act for the uses and purposes mentioned in the <br />instrument. <br /> <br />Subscribed and sworn/affirmed to before me this this ____ day of __________________, 201_. <br /> <br /> <br />(Notary Seal) _______________________________________ <br /> Notary Public in and for the State of Washington <br /> <br /> Residing at <br /> <br />