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� <br />gy City Ordlnance any meter "sunn!ying more than one nremiaes qx user'� <br />shall be treated as a Water Distrtict and comnly with 'dRter District <br />regulatlons. <br />WftEyerettriUti11t1eseDenartmentflEVeTPttnd'rlashington196201ID tIttmaycbey <br />° � with your nayment or senarately. If you have any <br />mailed or brought n. �t 259_8785• <br />questions. nlease call Mr�• �app <br />Please return the comnleted form within 20 days of receint o: <br />p?rs. SapP - Utility Billing <br />City of E'�erett <br />gverett, Washington 98201 <br />, 41AT� E_R DISTAIC��RT <br />N�e of Water District (if any)_�x�$$ Valley Water Association, Inc. <br />Treasurer of rayer: Cross Valley <br />Water AssociatioTi� Inc. <br />Name <br />_ .,_.. i zi <br />"-�— pddress <br />Snohomish, Wa• 98 <br />City, State, Zin <br />568-6766 _ <br />90 <br />persons to not.ify in case of emergency - ATame, Address, Teleohon� ATumber: <br />,�;. Gary Hajek, Manager 568-6239 <br />Harry �aalste� 568-7515 <br />�` , <br />20416 - 87th Ave. S.E. <br />16220 Three Lakes �• Snohomish, wa• 9a290 <br />Snohomish, Wa. 98290 — <br />Carole Gabrio 56_ a-4_ 8�_. <br />6317 No. Ridge Dr. <br />Snohomish, Wa• g829D — <br />Total number of services aonnected to the master meter, <br />present number of services in use_ <br />Account Number � <br />Tan Number „ <br />Size of Service ---- <br />Date Mail�d_ - "--' <br />� <br />� <br />240 <br />240 <br />� <br />;z <br />