HomeMy WebLinkAboutmisc doc WATER COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728'I{T:PIERCE FL 34982
SEWER RES �/
NAME'S` AO—Lid c t ALJ
METER SZ. M/F 3
ACCT.# SCJ
F IRR
SECURITY DEP SERVICE ADDRESS 6301 LIA5� t
SERVICE FEE I'
SAMEDAY FEE
SUBDIVISION l.. LOT BLOCK
, Ir OVERTIME FEE I
q54 METER INSTALL.' BILLING ADDRESS
CFC/WATER
FPUA CFC PHONE#- " 7 7 Z—?--SZ�3 OVE IN/CLOSING DATE
CFC/SEWER j
This application hereby request and authorizes the,Utility to render water and/or sewage disposal
GUAR REV services to the premises described above in accordance•with the Utilities present or future rates,
LATERAL rules and regulations,which by reference are made a'part of this contract Applicant agrees to pay
19 the Utility promptly for such services in accordance with the established rules and regulations.
$ TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SOCIAL SECT ^�
SIGNATURE FED ID ✓ ,1
NAME OF SPOUS& ^"'" SPOUSE SOCIAL SEC.,
I OFFICE USE ONLY,r 1;
DATE RECEIVED 1�i j CASA Gpme* Y 4 'l ' RECEIVED BY
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