HomeMy WebLinkAboutSLC Utilities invoice` WATER
C6
SEWER
RES
METER SZ.
MIF
E
RR
S
SECUATi'Y DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL.'
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
§ r
TOT
CUSTOMER
SIGNATURE
NAME Z]LO-I/
IS `V�I- / vd iTlxllPJ7 V'(
ACCT. # 9 C
SERVICE ADDRESS 04 S 5
�LS"TDY1 LOT I v BLOCK
-��w
PHONE #_ `9V 7 - DJ % y MOVE IN/CLOSING DATE
This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay
:he Utility promptly for such services in accordance with the established rules and regulations.
-USTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE
SOCIAL SEC/
FED ID — ✓W/tl % `Y
NAME OF SPOUSE SPOUSE SOCIAL SEC.
r. TdTC Dann� 1 rg OFFICE USE ONLYt e) �r r ti
01