HomeMy WebLinkAboutWORK ORDER - 04-00370 - 272 Pollard Ave - New SFRWORK ORDER
ACC# RT# PHONE EFFECTIVE DATE DATE to
NAME W-op>peZu/cvo game!; SERVICEADDRESS 277_ Po���si�
MAILINGADDRESS 3y7 Pe&,, Re i.&Jzra rD D
OWNER PHONE 33[,-SKxib NO. OF PEOPLE
ADDRESS
EMPLOYER OR RELATIVE WORK PHONE
COMMENTS
SS#
SIGNATURE
❑ IN
❑ READ
❑ RENTING
❑ ON
❑ RE -READ
❑ BUYING
❑ OUT
❑ CHECK LEAK
❑ SELLING
❑ OFF
❑ WTR.SWR ONLY
❑ OWNER
[]VACANT
❑ GR CONT #
❑ BL CONT. #
METER SIZE _
LOCATION
COMPLETED BY
DEPOSIT AMOUNT
DATE PAID IN
REFUND DATE _
AMT REFUNDED _
AMT. APP. BILL
GR RT# BIN SIZE NO. OF BINS F S
El El [I [I [IF
❑
ISSUED BY
❑ COMPUTER FILE