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<br />~ <br /> <br />,i''''' <br /> <br />n <br />w. <br /> <br />,~,,,.,\ <br /> <br />. ~" <br /> <br />I~~~ <br /> <br />PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919 <br /> <br />03- '~~l( <br /> <br />CITY OF ZEPHYRHllLS <br />ZEPHYRHllLS, FLORIDA <br /> <br />WATER ACCl. NO. <br /> <br />DATE <br /> <br />7'- /1;- rP .5 <br /> <br />OWNER/ <br />RENTER <br /> <br />,f1~ <br /> <br />~ <br /> <br />MAIUNG <br /> <br />,') <.2 <br /> <br />/1 <br />~. <br /> <br />-=j 75 J (p ~vf !/alYt~d: oL/ <br />~ATER <br /> <br />o SEWER <br /> <br />Lr <br />Ie:: <br /> <br />SERVICE ADDRESS <br /> <br />SHUT OFF SERVICE 0 <br />TURN ON SERVICE Q,.,/ <br />INSTALl METER .ffi-/ <br />READ METER 0 <br />CHECK METER 0 <br />OTHER 0 <br /> <br />o GARBAGE <br /> <br />~~ CITY <br /> <br />o OUT CITY <br />~ No. OF UNITS <br /> <br />_ DEPOSIT AMOUNT <br /> <br />31;. ( tl./":Er ~ <br /> <br />_ AMOUNT LAST BIU <br /> <br />_ DATE <br /> <br />_ MISC. CHARGE <br /> <br />VVORK COMPLETED BY <br />& DATE COMPLETED <br /> <br />ORDER TAKEN BY <br /> <br />-/~-Cd if <br /> <br />ORDER GIVEN BY <br /> <br />x <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 & return to offICe. <br />