HomeMy WebLinkAboutS L C UTILITIES RECEIPT— — — -- — -- --- - ---- SCANN1:zn ----- -
XWATER
SEWER
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METER SZ.
M/F
IRR
SECURITY DEP
SERVICE FEE
SAME. DAY FEE
OVERTIME FEE
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CUSTOMER
SIGNATURE
NAME OF SPOUSE
DATE
uC e COUntY
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SERVICE ADDRESS
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PHONEft4&/- /ory d - 136- // MOVE IN/CLOSING DATE
rhis 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,
vles and regulations, which by reference are made a part of this contract. Applicant agrees to pay
he Utility promptly for such services in accordance with the established rules and regulations.
.USTOMERS DEPOSITS ARE NONNEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/ 5-q -197)V q j
FED ID
SPOUSE SOCIAL
CASH OFFICE USE ONLY
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RECEIVED.BY