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HomeMy WebLinkAboutSLC Utilities Receipt_ WATER �? SEWER © METER SZ. COMM _ RES M/F IRR rY $ SECURITY DEP SERVICE FEE SAME DAY FEE h OVERTIME FEE - t-� METER INSTALL.' CFC/WATER FPUA CFC CFC/SEWER GUAR. REV, s — kr n �j� LATERAL ao ? 66 _ TOTAL SUBDIVISION ' V aa��•� � �^-- L1/w� O/lT �CJ _�LO�CKI I1 V , /� � This application hereby request and authorizes the Utility to render water and/or sewage disposal services to the premises described above is 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 NON NEGOTIABLE OR TRANSFERABLE. CUSTOMER SOCIAL SEC/ SIGNATURE d FED ID -- Q h,, E OF SPOUSE SPOUSE SOCIAL SEC. OFFICE USE ONLY