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<br />.~ <br /> <br />EJ <br /> <br />PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919 , <br />< <br /> <br />~~ <br /> <br />CITY OF ZEPHYRHILLS <br />ZEPHYRHILLS. FLORIDA <br /> <br />() 2 - C)~) f''j <br /> <br />WATER ACCl. NO. <br /> <br />DATE 7'- /f-~~ <br /> <br />OWNER/ <br />RENTER <br /> <br /> <br />.- <br /> <br />J;,c . <br /> <br />MAILING <br /> <br />SERVICE ADDRESS j 7 s: f 5'" 7J1I'J~ P'~ U:r- <br />Q....-1NATER <br />SHUT OFF SERVICE 0 <br /> <br />TURN ON SERIIICE 0/ <br />INSTALL METER a/ <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 UNIlS <br /> <br />- DEPOSIT AMOUNT <br /> <br />~ I, Ub 1fli!j;r <br /> <br />- AMOUNT LAST Bill <br /> <br />_ DATE <br /> <br />_ MISC. CHARGE <br /> <br />WORK COMPLETED BY <br />& DATE COMPLETED <br /> <br />ORDER TAKEN BY <br /> <br />Retain white form in office at all times. <br />Send pink & yellow forms to Water Service t. <br />Water Service Dept. to sign yellow form & return to office. <br /> <br /> <br />;'~l.,)~l.q.;/.ri~':'+<,. -.. -;; <br />- '~~'. . .'.',",'<.'. .--............................................. <br />HKCIIUICAL, . COMPANY. <br />d.~,,',: I STATE CERT OR REGIST # <br />SIGNATU~, CITY PROCESSING' # '.~'71 S-C:> <br /> <br />-- -.. .. .,------..- ... <br /> <br />. 11"1........., <br />. <br /> <br />.. ..-.. ............. <br />_~".~1J"tI:..-.i:. ;~~'''';4.: *:"'"' . ~ "' <br />"'I,'~\u\t:l.~l"j~.."}, 't '.~i..,''l <br />~~" ., .~".~..."".!. <br />._~.,.,.....,'~ . <br /> <br /> <br /> <br />,"I"t ",J,'" <br /> <br />................................................... <br /> <br />_If ,)r;:~~.). .} <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING . <br /> <br />1.:\ <br /> <br />:-.~...\)'1J;.' :. >>.i'"r,,;; <br /> <br />.,~~.~..._-.. <br />.',"*.~~'WNI~.';"'"t',~ ';-';:$ :.:.,:' .~ '. "', <br />................................................................. <br /> <br />~ ';';! ,~~ .~...::_.-+ ~~, ,,('~. <br /> <br />.. ,. .;'b5:, ~~~..~~;;~:~.;' r:......~ ~.~.j :{;. ., <br /> <br />- ',-,., ,,1" "-!,4t.:'- ..' ..~.,'.. <br />: i.i~f#-it:$r ~l/I>>.~ <br /> <br /> <br />