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<br />n <br /> <br />n <br />~ <br /> <br />Ii <br /> <br /> 105763 ~ <br />f"". 1""\ ("I ('") ('J (1 n <br /> <br />PERFORMANCE BUSINESS PRODUCTS, INC. 813-719-8008 FAX 813-719-7919 <br /> <br />C2140 <br />CITY OF ZEPHYRHILcs-" <br />ZEPHYRHILLS, FLORIDA <br /> <br />WATER ACCT. NO. <br /> <br />DATE <br /> <br />/; -- ~:<'-O5' <br /> <br />OWNER/ W <br />RENTER ~ <br /> <br />Q~j7~ a f)}f~ <br />MAILING ei:J..l/~f 1~.Li'j)~ ~~ <br />~O;" FI. .J'~t.~7 <br /> <br />SERVICE ADDRESS 0 :l ~ / <t1 Lit. <br />~ <br /> <br />SHUT OFF SERVICE <br /> <br />o <br /> <br />WATER <br /> <br />TURN ON SERVICE ~ <br />INSTALL METER \~. <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 UNITS <br /> <br />_ DEPOSIT AMOUNT <br /> <br />+, w;;J;:;;- An;tu <br /> <br />_ AMOUNT LAST BILL <br /> <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 Serv' e pI. <br />Water Service Depl. to sign yellow for & eturn to office. <br /> <br />