HomeMy WebLinkAboutSLC Utilities invoiceWATER
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NAME
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ACCT. #
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IN/CLOSING'DATE
This application hereby request and autharizes,the Utility to render water and/or sewage disposal
services to the. premises described above imaccordance with the Utilities present or future rates,
rules and regulations; which by reference are made apart of this contract. Applicant agrees to pay
the Utility promptly for such services in accordance with the established rules and. regulations.
CUSTOMERSDEPOSITS ARE NON. NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SOCIAL SEC/ G�`�� -�•
SIGNATURE FED ID
NAME OF SPOUSE _ SPOUSE SOCIAL SEC.a "f>
r OFFICE USE ONLY
DATE RECEIVED'-4/' VO CASH CHK # 03tV6;1.. RECEIVED BY J Ck