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f3y Cit,y Ord7nnnce nny r.�r.ter °�unn] S�;g more Chnn one nremises or uaer�' <br />snRll be rrrated ns � b!nt.er llistrl t and com��ly �vlth b7ater Distrlct <br />rr.,gu.l�ztion: . <br />'dnter I)LctrlcCs nr� rcauir�+d. to PS '. ln and .retnrn this form to the Clty <br />/� of Evet�ett, ULil.7.tia. T�r.nnrtnent, �vr;rntt, :�In.;1:1n�;Lon 9f1201. It mny be <br />���'� mniled or UroughC ln, �St;h your rny,nr.nG or sennrabel;�. IP you have any <br />' questions, �le�se c�ll ;�.rs. SaPp ac ?.�9-£�78�, <br />ple�se r,eturn the c�T^leted 1'orm vrithln 20 dny:= of' rece',nt to: <br />�'rs, S.t`in - iltillty <br />C1ty oL E�ere�t <br />�;vrrett, Wn�hinRton. <br />itlllln;; <br />�,97_ O1 <br />' 1A'tF.�; DI;;TiiIC'P �,r:o;•nr <br />tJame of' l�later Dlstrlct (1; any)�y��..e�°l'.�{�.Ue �iad�t,a�' U.iI-u <br />Tre�sui'er of ntiyet': -Margerbtlicdeea' <br />�.j.1- ^ fi125 _ 139Cy Avenvc S$ <br />Smho�uidi� yi'ash. 99290 <br />pldress <br />� C1ty, StnCe, Lln Cod� <br />5 ��'- y9� <br />Tr_lenhun� !;umt <br />person: t:o notify in case ct' ererg��ncy -?<^Te, f�ddres�, 'f�]enhone Clumber: <br />; <br />/�1 — Tt �y;Amt Hedeari' -�'� <br />�i <br />Su:...�lsh� Wudi. 98Z90 <br />� (� �' - �-( � 0 I <br />N<•.,n�_ �1 �,Q.�.�,-�.�� � y �:: l l'ti 3�`'O S�, <br />' ��,� v: s�•---.(1,t�� ' 9.� G_ a,.�a <br />� E3n�c.�e.w '(Zc.��� ,.�',�,�.C.i,�,.�.� � <br />b � -., m - �.4P„10-.i3f�- ��"da �r�-r [��on,Q�a� s,��\ <br />F� - � !c �-_ L�' F� �/ �Sr/ _ `lSl,f�� s� <br />Tot�l number of _ervlces connected to the a�.ister metrr o( � _ <br />nresent numbrr of ��rvlces in usP �/ ^ <br />(,�count i�umher �/%��� <br />I'an ,�umber �`�_ <br />;iize of Service � �� <br />llate hir�lled .�-/d" a <br />�1 <br />� <br />