HomeMy WebLinkAboutSLC Utilities Receipt, WA=-% COMM.
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- SERVICE FEE
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OVERTIME FEE -
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CFC/WATER
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_ CFC/SEWER
GUAR. REV:: This applicationhereby 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,
LATERAL rules and regulations, which by reference are made a part of this contract. Applicant agreesto pay
$ - I' + {, ) ' - - TOTAL the Utility promptly for such services in accordance with :the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER, - SOCIAL SEC/
SIGNATURE - FED ID _ �� �(U�
NAME OF SPOUSE SPOUSE SOCIAL SEC,
�y)�,�+ OFFICE USE ONLY
DATE RECEIVED /�J CASH RECEIVED