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� <br />BY City Or¢inance .�ny mr.ter "sunn] <br />shall be treated fl.^, a 41ntPr Di:atrl <br />rnja.laCions. <br />�rinter Distr�ct:s �u•�� t'cqu11'n�l to fi,l in �nd .+.�et��rn this form to t.�e City <br />of Lverett, Ut:Llitl^.^. i�r.n;�rt�;�t�.'�lm�1tt�r ;�en`.i:at.ely.�eIf1youlhaveYany <br />mailed or Urou�;ht f.n, with � <br />questions, nlease c.,ll ;'.rs. 6ctipp aL 259-h785� <br />Please xeturn the c�m*�l�ted form withln 20 cia;�:= nt' rr,ceint to: <br />, ' sr�, ,g.�?p - llti.lity Billir,�, <br />C7 ty of F.verett <br />i;v�rett, W�shington ?.�2�7 <br />Lng mora th-�n onr. nr�mises or u3er" <br />t and com��ly �•rlth 4later Distrf.ct <br />';lATi?!? 17I5'CitIC'�_ <br />t�;�me of 41at.er Distrlc.t ( if nnY? <br />Treasurer ot' nnyer: ��/��'/ r � ��rCr14t�1 -- <br />�� Z.. n <br />�/l,//-� ��� ��F� <br />, � r / Add1''e�^� � , _.._ _ ., n <br />Clty, Stnte; Lin <br />7 �� <br />c � <br />Telerhone ^:um <br />CH <br />person� to notlfy .n c�ase of emer�ency -:dame, Gd.dress, Telenhone Number: <br />� ��6C1'� /�� �l �TCs9 <br />,�l /D /�i/�r�'G S� ' <br />�.. n�a/I'�� � �il[ � �%�i�a��) <br />33y-✓y/` <br />�O 6 Am ��r e- — <br />/UU/.t �73fY „�� <br />r�e%--�,i'r4 l�Ic� . 9P.tS'a <br />:?3Y-6£�o y <br />i i ��/� % o �'�� <br />n, ; � � �7 � P/, s, � � <br /><<�lro.�.'sl� Ge.H � `"�i�%�' <br />33U-�'1 � r y <br />'Potnl number of srrv'ce> connected to th� r.�astif=I' r.�t"-r <br />nrr,ent numbcr of s�rvic.r.:s ln use_ <br />Account Nunber_J <br />� <br />Tar ;lumber / � "� i <br />Slze of Service �� <br />Date Malled �/J � <br />