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01-0122
Zephyrhills
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Building Department
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2001
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01-0122
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Last modified
3/6/2009 2:43:21 PM
Creation date
10/3/2006 9:21:13 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
01-0122
Building Department - Name
G H D
Address
NORTHLAKE DR
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<br />~ <br /> <br />El <br /> <br />'" <br /> <br />PERFORIlAANCE BUSINESS PRODUCTS. INC. 813-71l1-3OO8 FAX 813-719-7919, <br /> <br />CITY OF ZEPHYRHILLS <br />ZEPHYRHILLS, FLORIDA <br /> <br />o /- 3~ 7 <br /> <br />WATER ACCT. NO. <br /> <br />DATE:1iI/O i <br /> <br />OWNER/ <br />RENTER <br /> <br />C~Yt ~'1. \ <br /> <br />1-40111'\ of' <br /> <br />~1Ie1Of^e,.,..J. G>rp <br /> <br />MAIUNG /-t59:2'! - 77!! :5r . <br />GJ~ aL~,,FZ -5:$~.;Z6 <br /> <br />SERVICE ADDRESS (., ~ 'lCo (VOr..l-l \0. ~@ l),.. . <br />lc-t- .& '22 <br /> <br />o <br /> <br />~ <br /> <br />WATER <br /> <br />SHUT OFF SERVICE <br /> <br />TURN ON SERVICE ]X <br />INSTALL METER )! <br />READ METER 0 <br />CHECK METER 0 <br />OTHER 0 <br /> <br />o SEWER <br /> <br />o GARBAGE <br /> <br />$ IN CITY <br /> <br />o OUT CITY <br />-L No. OF UNI1S <br /> <br />_ DEPOSIT AMOUNT <br /> <br />J/tf" ~ fV\~- <br /> <br />_ AMOUNT LAST BIU <br /> <br />_ DATE <br /> <br />_ MISC, CHARGE <br /> <br />WORK COMPLETED BY <br />& DATE COMPlETED <br /> <br />J./~'1o I <br /> <br />ORDER TAKEN BY <br /> <br />Retain white fonn in office at all times, <br />Send pink & yellow forms to Water Service Capt. <br />Water Service Dept, to sign yellow form & return to <br /> <br /> <br />leAfi <br />
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