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STATEMENTS OF UNDERSTANDING
<br />I understand that approval by Kittitas County only verifies my intent and that it does not guarantee that
<br />there is a legal right to waters of the state, or that the pre-existing water source meets state or local
<br />requirements for potability and/or quantity for the proposed use, or that WAC 173-539A does not apply to
<br />the pre-existing water source. As the applicant, I assume all risk in its entirety and agree to indemnify
<br />defend and hold Kittitas County, its departments, elected and appointed officials, employees, and agents,
<br />(Initials)
<br />harmless from and against any and all claims, damages, losses and expenses, including reasonable
<br />attorney's fees, for any bodily injury, sickness, disease, or death, or any damage to or reduction in value of
<br />property including the loss of use resulting therefrom which are alleged or proven to be caused in whole or
<br />in part by a negligent act or omission of its officers, directors, and employees. As the applicant, I
<br />understand that the purpose of this application has been made with the intention of seeking issuance of a
<br />building permit, I understand that I am legally and financially responsible for ensuring there is a legal right
<br />to the water to be used, and that all water supply systems are engineered, designed, constructed and
<br />maintained in accordance with federal, state and local requirements.
<br />I understand that Kittitas County Public Health Department (KCPHD) strongly recommends that I consult
<br />with the Department of Ecology prior to submitting this application. I also understand that this application
<br />(Initials)
<br />is a public record that may be reviewed by the Department of Ecology who may ask me for proof of any
<br />assertions I make on the application, and has the ability to enforce WAC 173-539A independent of any
<br />Kittitas County actions.
<br />I understand that the federal, state and local water quality requirements are a minimum requirement for
<br />water quality testing, and that local conditions may result in contaminants that are not detected by these
<br />tests. As the applicant, I assume all risk in its entirety and agree to indemnify, defend and hold Kittitas
<br />County, its departments, elected and appointed officials, employees, and agents, harmless from and against
<br />(Initials)
<br />any and all claims, damages, losses and expenses, including reasonable attorney's fees, for any bodily
<br />injury, sickness, disease, or death, or any damage to or reduction in value of property including the loss of
<br />use resulting therefrom which are alleged or proven to be caused in whole or in part by a negligent act or
<br />omission of its officers, directors, and employees.
<br />I understand that adding a 2nd and/or additional residential connections to an individual well, including
<br />(Initials)
<br />accessory dwelling units, categorizes the well as a Public or Shared Water System which requires submittal
<br />of a Public or Shared Water System application and approval by KCPHD or Washington State Department
<br />of Health.
<br />(Initials)
<br />i certify that I have read and understand the Adequate Water Supply Determination Instructions and Form.
<br />Property Owner Signature: Date:
<br />***The adequate water supply determination approval remains valid only if the facts asserted and
<br />governing law do not change, and expires within 1 year of issuance. All applicable fees may be non-
<br />refundable. ***
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