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<br />~ <br /> <br />1'""') <br /> <br />n <br /> <br />~ <br /> <br />PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919 <br /> <br /> 103110 ~ n <br />() () 0 0 .. n <br /> .~. <br /> <br />.. <br /> <br />CITY OF ZEPHYRHlllS <br />ZEPHYRHILLS, FLORIDA <br /> <br />i - 66'8 r:J. <br /> <br />SERVICE ADDRESS <br /> <br />DATE / d//~/b 'f <br />~~ \)" J~ty;"^J>/ ~- <br /> <br />MAILING _1 A30 j t-fL--J { 30 I <br />M~ Ll t-I, 8. 3 3S.+ 5' <br />71:<5 C:,~ blvel. / <br />~R <br /> <br />OWNER/ <br />RENTER <br /> <br />WATER ACCT. NO. <br /> <br />SHUT OFF SERVICE <br /> <br />o <br /> <br />TURN ON SERVICE <br /> <br />0/ <br />cvl <br /> <br />o SEWER <br /> <br />READ METER <br /> <br />o <br /> <br />o GARBAGE <br /> <br />~rrY <br /> <br />INSTALL METER <br /> <br />CHECK METER <br /> <br />o <br /> <br />o OUT CITY <br />-1- No. OF UNITS <br /> <br />OTHER <br /> <br />o <br /> <br />- DEPOSIT AMOUNT <br /> <br />- AMOUNT LAST Bill <br /> <br />3 Ii..{ I( <br /> <br />_DATE <br /> <br />w;iw .~ <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 De . <br />Water Service Dept. to sign yellow form & return to office. <br /> <br />