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shalltbe�tieatedeasna Water Distri4•tnand comnhynxlth Water$District r" <br />regulations, <br />Water Districts are required to fiil in and return this form to the City <br />n of Everett, Uti11t1es Dennrtment, Everett, :�lashington 98201. It may be <br />t""+ mailed or brought in, with your rayment or senarately. If you have any , <br />�✓ .questlons. nlease call M.rs. Bapp at 259-R7A5• <br />please return the comTleted form withln 20 days of receint to: <br />Mrs. Sapp - Utility Bllling <br />City of Everett <br />Everett, Washington 9.g201 <br />41ATER DISTRICT RE°ORT <br />Name of Wate: Mst:^Sct (if any) A� � ���'r `� �'�'^E�w'ti�-�Z ' <br />5(�Y�HS�''1�rayer:_ Q. 1_..-QU1�TF�ME-i(V <br />- , arowC , %\ � <br />e, Zin Code <br />r <br />Persons to notify Sr case of emer�ency - Name, Address, Telenhone PTumber: <br />('��_�,,. ,��ol-`t`l.,r�.! <br />�� <br />�� . <br />_.., .,.._< (2.� <br />� <br />= <br />��='�.'�r'_�� <br />Total number of services connected to the master meter 1:�- <br />�resent number of services in use ,� <br />Account Number � <br />Tan Number_ �� <br />Size of Service <br />Date Mailed �/ � %�[1 <br />: <br />