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01-0578
Zephyrhills
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01-0578
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Last modified
3/6/2009 2:41:32 PM
Creation date
10/19/2006 9:02:31 AM
Metadata
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
01-0578
Building Department - Name
TENBRINK,GORDON
Address
39128 OLD MILL RD
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<br />.~ <br />~~~ <br /> <br />-E] <br /> <br />F'ERFORMANCE BUSINESS PRODUCTS. INC. 813-'719-8008 FAX 813-719-7919 <br /> <br />CITY OF ZEPHYRHILLS <br />ZEPHYRHILLS, FLORIDA <br /> <br />WATER ACCT. NO. <br /> <br />DATE <br /> <br />9 / 1~ tv I <br /> <br />OWNER/ -r- v. \" <br />RENTER . I e^ l)!"..'\ l(" <br /> <br />4 ASSOc. <br /> <br />MAILING <br /> <br />SERVICE ADDRESS S'c; I :1 ~ old /!A. 1, \ <br /> L,-:;Jt ., <br />SHUT OFF SERVICE 0 -r <br />TURN ON SERVICE ~. <br />INSTALL METER ~ <br />READ METER 0 <br />CHECK METER 0 <br />OTHER 0 <br /> <br />, <br />L../\ . <br />~ WATER <br /> <br />o SEWER <br /> <br />o GARBAGE <br /> <br />Jif- IN CITY <br /> <br />o OUT CITY <br />~ No. OF UNITS <br /> <br />_ DEPOSIT AMOUNT <br /> <br />_ AMOUNT LAST BILL <br /> <br />_ DATE <br /> <br />s jlf I' WC:ttu <br /> <br />t"'-e+ e.., <br /> <br />_ MISC. CHARGE <br /> <br />WORK COMPLETED BY <br />& DATE COMPLETED <br /> <br />ORDER TAKEN BY <br /> <br />'7/Hc (0 I <br /> <br />Retain white form in office at all times. <br />Send pink & yellow forms to Water Service Dept. <br />Water Service Dept. to sign yellow form & retum to office. <br /> <br />
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