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<br />(""', <br /> <br />(1 <br />~ <br /> <br />('1 <br /> <br />r, <br /> <br />(", <br /> <br />n <br /> <br />('l <br /> <br />103110 <br />n n <br /> <br />fQ3 <br /> <br />(1 <br /> <br />PERFORMANCE BUSINESS PRODUCTS. INC. 813-719-8008 FAX 813-719-7919 <br /> <br />5-D3'1-4 <br />CITY OF ZEPHYRHILLS <br />ZEPHYRHILLS, FLORIDA <br /> <br />WATER ACCT. NO. <br /> <br />DATE <br /> <br />,z/J";:S- <br />I / <br /> <br />OWNER/ <br />RENTER <br /> <br />f?y~ (l~ <br />,/UU ~- <br /> <br />MAILING <br /> <br />SERVICE ADDRESS <br /> <br />31Lf~Y ~ !kn~dr, kt~ <br /> <br />@....wATER <br /> <br />o <br /> <br />SHUT OFF SERVICE <br /> <br />TURN ON SERVICE <br /> <br />~ <br />~ <br /> <br />o SEWER <br /> <br />o GARBAGE <br /> <br />INSTALL METER <br /> <br />READ METER <br /> <br />o <br /> <br />m-"1N CITY <br /> <br />CHECK METER <br /> <br />o <br /> <br />o OUT CITY <br />~ No. OF UNITS <br /> <br />OTHER <br /> <br />o <br /> <br />_ DEPOSIT AMOUNT <br /> <br />_ AMOUNT LAST Bill <br /> <br />3/. (( <br />/<-f - <br /> <br />tJ~~ <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 Depl. <br />Water Service Depl. to sign yellow form & return to office, <br /> <br /> <br />___ c2 --tf--ZJ 5 4r <br /> <br />~'1f~DERL <br />