HomeMy WebLinkAboutS L C UTILITIES RECEIPTWATER COMM
SEWER RES
METER SZ. M/F
IRR
$ / �' "J G/V SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METERINSTALL.'
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
TOTAL
NAME. OF SPOUSE
NAME-t Q�
AC&. # I OC
SERVICE ADDRESS
BILLING
PHONE A . -�96 J /G— V yl / MOVE INICLOSING
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,
pules and regulations„which by reference are made apart. of this contract. Applicant agrees to pay
the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NOOjN NEGOTIABLE OR TRANSFERABLE. -
FEDIA S.'f. Yy
SPOUSE SOCIAL
OFFICE USE ONLY ^ ,�
DATE RECEIVED CASH CHK # RECEIVED By/ V1
a