HomeMy WebLinkAboutUtility InvoiceV/WATER
RES
V SEWER
(METER
c.5 SZ
M/F
IRR
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SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
(J /.r 040
METER'INSTALL.
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CFC/WATER
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—942Q
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CFGSEWER
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GUAR: REV.
$
CUSTOMER
SIGN
NAME OF SPOUSE
DATE RECEiVEDA
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ACCT # _ a I L_t t r
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SERVICEADDRESS ('1m
SUBDMSION aJ- LOT,O BLOCK
BILLINGADDRESS
PHONE #�VO ` ( MOVE IN/CLOSING DATE
�� pp�t, hereby request and authorizes th tility 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 arc 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.
IALSEG
FED
FED ID CO
SPOUSE SOCIAL SEC.
CE I#% ONLY
CASH —CHI{ # . - - RECEIVED BY
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