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HomeMy WebLinkAboutSLC Utilities Receipt_ WATER �t SEWER © METER. SZ. COMM _ RES MIF :>�eR $ SECIMM DEP SERVICE FEB SAME DAY`FEE OVERTIME FEE METER INSTALL.' CKIWATER FPUA CFC CFGSEWER GUAR. REV. LATERAL LL TOTAL \. 1 6 " / SERVICE ADDRE55 ...:,'.. — i #" SUBDIVI$It3N ��'�—�1 L �'�L9-- LOT �� � `.BLOCK_ PRONE # 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 the Utility promptly for such services in accordance ivith the established rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. CUSTOMER SOCIAL SEC/ SIGN FEDID NAME OF SPOUSE. SPOUSE SOCIAL SEC. OFFICE USE ONLY