HomeMy WebLinkAboutSLC Utilities ReceiptWATER
COMM
SEWER
Lf
_It=RBS
METER.SZ,.
MIF
WE) 6�
MR
$
SECURITY DEP
SERVICEPEE
SAMEDAYP$$
OVERTIME PSB
-
'L ""7�`Y•
L1
METER INSTALL.'
l*�•
CPCIWATER
PPUACFC
CPC/SEWER
GUAR,
REV.
TOTAL
CUSTOMBR
SIGNATURE
NAM$
ACCT: if
SUBDIVISION!L.) CY//, n -/Q, /LOT BLOCK. 3
BILLING ADDRESS_ fDD� UcL1-rit.rv, �idC
-36urr%n Beaj,) ., R 331/,�L(,�
PUGNB tb�1 „gip ^ 3.�% J MOVE IN/CLOSING DATA
This application hereby request and sulhorfies Ilia Utility to render water and/or sawage disposai
sorvioes to the promises described above in accordance with the Utilities present or fhmre rates,
miss mrd regulations, which by reference am made gputt of this contract. Applionnt agrees to pay
Ilia Utility promptly for suoh services ht accordance with: the ostabiishcd. Weiss and regulations.
CUSTOMERS DEPOSITS. ARE NON NEGOTIABLE. OR TRANSFERABLE.
SOCIALSECI �+-��/ �)
PRO ID iii — 3ML.— � -
SPOUS$SOCIAL SEC.
DAT$RECEIVRQ, —! A CASH ORRICL+U3 CHKiIXI I R$CS1V$D