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SIGNATURE
NAME OF SPOUSE
SAMEDAY FEE
OVERTIME FEE
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SERVICE ADDRESS
DATE
,Ibis application hereby request and authoriies 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
the Utility promptly for such services in accordance with the established rules.and regulations.
CUSTOMERS DEPOSITS ARE. NONNEGOTIABLE OR TRANSFERABLE.
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