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HomeMy WebLinkAboutSewer InvoiceWATER. Comm SEWER Y RES METER SZ. M/F D�j IRR $ 9 — SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE METER INSTALL. CFC/WATER FPUA CFC p CFC/SEWER GUAR. REV. LATERAL 'AL. NAME OF SPOUSE ACCT. # C�J t0 4 CO 6 SERVICE ADDRESS (0 SUBDIVISION L/"'�3G��2 LOT BLOCK_ BILLING ADDRESS SS-b ;JD 4W PHONE # -7-7o Cr ! %L� MOVE IN/CLOSING DATE This application hereby request and authorizes the Utility 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 are 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. SOCIAL SEC/ � i - ` („r1 1 FED ID SPOUSE SOCIAL SEC. M OFFICE USE ONLY ^,n �Q DATE RECEIVED a� q " CASH CHK # / RECEIVED BY / t�''4