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HomeMy WebLinkAboutSLC Utilities ReceiptLWATER COMM SEWER _)L RES METER SZ. M/F � ©a MR SECURITY DEP SEiLVICE FEE -- SA14iE DAY -FEE OVERTfm PEE' • Q� MEMINSTALL. CFCfWATER —� FPUA CFC CFG1SEWER GUAR REV. _ LAT" EL&L •USTOhm IGNATURE AM." OF SPOUSE FL ACCT. # M SEFVICE ADDRESS L) 3 (P 1 r S'i Q Q� BLOCK BILLINGADDRESS 4jf-&O-c-L)* j 3 PHONE # U J r MOVE -/CLOSING DATE �s� {7� u'car�yy fr .� /EPF� c� C L''a�N�1�r'V-r TNS This application hereby request and mufi�oni ;the Utility to reader water and/or sewage disposal services to the premises descnbed 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 UtMty promptly for such scryices in accordance with the established rules and regulations. CUSTOM MS DEPOSITS ARE NON NEGOTIABLE ORTRANSFERABLE- FEDID SEC/ 5� FED ID Jt1(I/ '7 SPOUSE SOCIAL SEG OFFICE USE; ONLY