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<br />n ~ <br />~ <br /> <br />n <br /> <br />(') (') 103110 E3 <br />C' c' . n n <br /> <br />PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719.7919 <br /> <br />CITY OF ZEPHYRHILLS <br />ZEPHYRHILLS, FLORIDA <br /> <br />\1- .55:;0 <br /> <br />WATER ACCT. NO. <br /> <br />DATE <br /> <br />lo/.:<;/~y <br />f <br /> <br />OWNER/ <br />RENTER <br /> <br />~j;;tf~k' <br />S~~ <br /> <br />( <br />E <br /> <br />A ss 0:::- , <br /> <br />MAILING <br /> <br />TJ1c . <br /> <br />SERVICE ADDRESS ~7.33 sr-457' <br />SHUT OFF SERVICE 0 <br />TURN ON SERVICE ~ <br />INSTALL METER cg/ <br />READ METER 0 <br />CHECK METER 0 <br />OTHER 0 <br /> <br />4T7 <br /> <br />% II <br /> <br />w:i!ir ;ni1t;- <br /> <br />I <br /> <br />, <br />I <br />r <br />I <br />I <br />i <br /> <br />WORK COMPLETED BY <br />& DATE COMPLETED <br /> <br /> <br />K <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 /> <br />~ATER <br /> <br />D SEWER <br /> <br />o GARBAGE <br /> <br />~CITY <br /> <br />o OUT CITY <br />( <br />_ No. OF UNITS <br /> <br />_ DEPOSIT AMOUNT <br /> <br />_ AMOUNT LAST BIU <br /> <br />_ DATE <br /> <br />_ MISC. CHARGE <br /> <br />ORDER TAKEN BY <br /> <br />/O-.2/-CJV ~ <br /> <br />ORDER GIVEN BY <br /> <br />~~&:J <br />