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� Print Form � <br /> CITY OF Z PHYRHILLS <br /> � UTI�iTIES ORK ORDER <br /> WATER ACCOUNT NO.: DATE: Sep 16,2014 <br /> OWNER/RENTER/BUSINESS:Butterfield mobile hame Ilc �p�yTACT PERSQN: Wayne ButterFietd <br /> MAILING ADDRESS: 4034 Gall Blvd PNONE RSUMBER: 813-937-525fl <br /> EMAIL AQDRESS: <br /> SERVICE ADDRESS: 37753 Prairie Rose Lp Lot 39 <br /> SHUT OFF SERVICE �X OX WATER <br /> TURN ON SERVICE ❑ ❑ SEWER <br /> INSTALC.MEfEFt �X ❑ GARBAGE <br /> READ METER ❑ �]X IN CIIY <br /> CNECK MEfER ❑ ❑ pUT CITy <br /> OTHER � <br /> DESCRIBE OTHER: 3/4 water <br /> NUMBER O UNITS <br /> DEPOSIT A OUNT <br /> AMOUNT ST BILL <br /> DATE <br /> MISC. CHA GE <br /> METER: FULL 3/4 <br /> IRRIGATION � <br /> WORK CQMPLETED BY&DATE ORDE TAKEi� BY: jackie boges <br /> COMPLEi'ED <br /> ORDE GNEN BY: �� <br /> Revised 9/2010 <br />