DEPOSIT = CALL FOR EXACT AMOUNT, AS THE AMOUNT OF DEPOSIT IS DETERMINED BY SERVICES PROVIDED AND DELTONA WATER METER SIZE. THE DEPOSIT MUST BE PAID PRIOR TO 255 Enterprise Rd SERVICE BEING CONNECTED. A LEASE OR PROOF OF Deltona, FL 32725 OWNERSHIP IS REQUIRED BEFORE SERVICE CAN BE 386-575-6800 STARTED, A SERVICE INTIATION FEE WILL BE BILLED ON . YOUR FIRST STATE Application for Service ‘Customer Number: FFICE USE ONLY Date Sonice Requestes:_12/26/2019. anon Voter ete | Baninesr day notion br To Taig ov Bene) Service Requested: Water_X _Wastewater___Irrigation_ Reuse ‘Customer Name: ce io Service Address:_1733 Morven Ct City Limits? Yes_X_No. Rent_X_ own Customer Mailing Address: _ 1733 Morven Ct City:__ Deltona state: FL zip Code: _32738 Home #: Work tt: cot: 318-433-1833 ema atencio mike @yahw.com Driver's License #: 001994 8! J Social Security #: T5O - (/-/665 Ifrenting — Please complete the following: COwners/Landlord Name:__ Gary Souder/J & M Properties LLC Address: 430 Summerhaven Dr Suite 200F city:_DeBary State: FL_ zip code: _32713 Phone Number, 386-574-4469 This application is notice that service is desired by the Applicant until notice is received from the Customer requesting Discontinuance of such service. The Customer hereby agrees to comply with the City of Deltona’s policies, ordinances and resolutions. Upon compliance the City of Deltona shall initiate service without unreasonable delay. Deposits are held for the duration of the account in a non- interest bearing account. By signing below you agree that the City of Deltona is not responsible for any water damage caused by taps of faucets left open and any obstruction or defective service lines. If the meter registers more that 10 gallons when itis tumed on the meter will be tumed off. A fee will be charged for a return visit. ‘Scheduling cannot teed for the same day. ‘Signature: LJIN Date: 1% 71 1 1 OFFICE USE ONLY DELIVERY OF THM INFORMATION. IN PERSON USPS MAIL EMAIL, FAX