HomeMy WebLinkAboutSLC Utilities ReceiptWATER i. Comm
SEWER. RES
ST LUc7E C STY -C
METER Sz: vf/F
mk
ACCT.
SECURITY DEP
SERVICE FEB
SERVICE ADDRESS
K
SAME DAY FEE
SUBDIVISION
OYERTIMB-FEE
0C)_ MBTBRINSTAL}l.'
GFC/WATER
BILLING ADDRESS
FPiiA CRC
CFC/SEWBR
PHONE #
t1Lat�l
CaN�ltoiV,�'
CUSTOMER
SIGNATURE •
NAME OF SP1
:w7v
LOT I r
GUAR REV.
This app ;cation hercby request aad authopzes the Utility to render water`and/or sewage disposal
services to:the premises descnbed "above k accordance with the Utilities present or future rates,
_LATERAL LATEEiAL rules and regulations, Which.by refdr,c" c-are made a part,of this coafract. Applicant agrees to pay
ly for such services in accordance with the established rules and regulations.
POSITS Am NON NEGOTIABLE OR TItANSFT'RABLE.
SOGIALSECI
SPOUSE SOCIAL; SEC.
OFFICE USE:ONLY
DATE RECEIVED.C2'3!v CASH .CHK # l 9 . RECEIVED $Y_