HomeMy WebLinkAboutSLC Utilities Receipt—L WATER COMM
SEWER RES
METER SZ. M/F
IRR
9 °a
$ SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
—:9391:0= METER INSTALL.
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
=1K6:0:=TOTAL
NAME
ACCT. #
SERVICE ADDRESS ,
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YHO # "EUJ " D J—/ L MOVE /CLOSING DATE
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This application hereby request and aut orizes 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 ibis contract. Applicant agrees to pay
the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER
SIGNATURE
N' ' OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED CASH CHK # RECEIVED BY