HomeMy WebLinkAboutUtility InvoiceWATER COMM
SEWER U/ RES
METER SZ. MIF
IRR
$ SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL.
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
TOTAL
CUSTOMER
SIGNATURE
NAME OF SPOUSE
rlv(o " ozli
ACCT. # ' /
SERVICE ADDRESS
/ LOT BLOCK
SUBDIVISION � � 3
BILLING ADRESS u9 7
V MOVE IN/CLOSING DATE
PHONE #
r sewage
This application hereby request h
orizes the Utility to render water andto
described above services to the premises e in accordance with the Utilities present or future rates,
icant
rules and regulations, fo s ch services in accolg
rees to Pay
rdance with the est bl shed rules and regulations.
the Utility promptly
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE -
SOCIAL SEC/
FED ID
SPOUSE SOCIAL SEC.
OFFICE USE ONLY RECEIVED BY L
DATE RECEIVED
�� CASH— (`) ��