HomeMy WebLinkAboutUtility Company ApprovalWATER
_ SEWER
METER.SZ.
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S§VE . QL ;ST
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M/F
IRR
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' SECURITY'DEP
SERVICE FEE.
SAME'°DAY FEE
��ll ;OVERTIME FEE.
3 . 00 METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
'GUAR. REV.
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TOTAL
COUNTY WATER:&.'SEWER DISTRICT (SLCU)
CUSTOMER APPLICATION
SERVICE ADDRESS' .+
SUBDIV..ISION W U2t�
.BILLING
EMAIL.ADDRESS-,
LOTT BLOCK= -�_
PHONE#D.9`7 MOVE IN/CLOSING DATE
Thisapplication.hereby requests and%authoriiesthe V.tility, to,renderwater, and/or.sewage disposal
services:,to the,premises described above in accordance with the'Utilities present otfuture ratesiTules and
regulations, Which,py reference nce are -made a part cf this,.contract. Applicant:agrees to pay, Utility- promptly for
such services in, accordance: with the.established-rules and.regulations.
CLISTOME115 DEPOSITS ARE NON NEGOTIABLE". -OR TRANSFERABLE:
APPLICANTAGREES THAT APPLICANT` WMLL; BEGINPAYINGG BASE FACILi°I'Y CHARGES FOR ME UTH=.SERVICE
APPLIED FOR 'ON 'THE DAY THE WATER METER OR :O.THER UT =' !SERVICE CONNECTION IS INSTALLED' ;AT
APPLICANT'S PROPERTY, REGARDLESS. °OF 'WM�N'APP- ICANT-STARTS UTIG MG THE. METER:AND/OR:SERVICE.
NAME OF,SPOUSE -SPOUSE;'SOC)AL,.
•.yy OFF.ICE.USE ONLY
OM-lDATE RECEIVED. +T CASH CHECK# . N RECEIVED BY