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By City OrdlnAnce nn,y meter <br />shall be tieated as a YIaY.er <br />re;gu�ations. <br />��sunn] ing.morr_ th:an one nremises or user" ; <br />Distri t and com»1�� with 47�ter.Dlatrict <br />',J�ter Districts nr� rrquirP��. to fi.:l. in and ,return tnis for.m to the Clty <br />ot Eve2•ett, Utiliti�s nenartment, �vr-.rrtt, ',lnshin�ton 9F32�1• It may be ^ <br />�� mailed or brought in, vaitn �ro a.r T:iyment or se�arntel;�. If you have any <br />questions, nlease c,all i'.r5. SapP �t ?59-&7�5• <br />please xeturn the c�mTleted ,`orm V�ithin 20 days of receint to: <br />;'rs. Sa?n - Uti.lity <br />C7 t; ot' Evere.'•t <br />I;v��rett, 4!ashir3ton <br />Billin�• <br />aII?_O1 <br />,rlATE3 DISTitICT ii:.v;�r+T <br />Naroe of' 4later District (i.` ���y) �u �'�� — <br />, <br />T�•easurer of rayer: <br />N:�m e <br />� pddress <br />� City, StnL'P, Zin Code <br />-7>7 �- D//ln <br />Telenhone n;umoer <br />?ersons to notify Sn c�..�e of emergency - l<a;re, bd.dress, T�:lenhone Number: <br />� <br />�� ;,. <br />t ,�. cyR+zL�s -,'.,�S:��P,2 <br />t�- � <br />�g�.�� � � ��< f'c c r , ����.�� <br />�,y,_,,.;y <br />V' <br />1 <br />c��9�14 P �"1 Sf' — <br />��z�z �e �2-Y �:o� 1�t�� ��' <br />/'s -,��roe. � �a- ��F ,�:- -- <br />�����9 <br />ha� e,['J� <C� c,as7r2�`% <br />�-g'li� l o��l� �'�� �� �- — <br />iJi.,,�foP v�l�. RB��'17-� �`'3'�I(� <br />� <br />Totr�l number of services connected to th� �naster meter <br />Present number:of services in use Z <br />Account Number / Q� <br />Tan Number ����� <br />S12e of Service <br />Date Nailed � ��-�d <br />