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SLC Utilities Receipt
_—X— WATER Comm U SEWER _ RES © METER SZ. MIF IRR $ SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE METER INSTALL.' CFC/WATER FPUA CFC CFC/SEWER GUAR. REV. If 14! § DcD LATERAL TOTAL SERVICE PHONE # %( � - 3 Y -f /LQ INULOSING DATE This 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 he Utility promptly for such services in accordance ivith the established rules and regulations. :USTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. SOCIAL SEC/ FED ID o) l0 NAME OF SPOUSE SPOUSE SOCIAL SEC. OFFICE USE ONLY