HomeMy WebLinkAboutMiscellanious Letter ( COMM SMMU UTII.iTiES:-P O BOX 728;FT PIERCE,'L34982
SEWER 77
RES NAME" LQI` C U
s'
ACCT#
TItR.
SERV
ICE ADDRESS
$ a:+ S`
I -
ECURITY DEF.
'dE FEE - 16.� u
1
SUBDIVISION / '`l LOT. BLOCK
OVERTIME FEE'
,y BILLING ADDRESS
1 1NIETER:INSTAIL ` t
CFC/WATER ;;
A
FPUCFC ! ""MOVE-IN SING DATE'
PHONE#
CFC/SEWER
S
GUAR.-REV This apphcaUon hereby reynest an aut ariz s the Utility to render water andlor sewage disposal.
ties`pre
services to the premises descnbed above in accordapce with?the Utzli sent or fpture rates;
LATERAL rules and rg$ulations,which by'refergnce are''made a part of this contract Applicant agrees t&pay
the;Utility promptly for`such services,io accordance with the`established rules and regulations;.
TOTAL CUS`J O�vIERS DEPOSITS'ARE NON NEGOTIABLE OR T1tANSFERABLE
GUS TOMER r SOCIAL SEC/:
SIGN1ATtJRL
j�
NAME ofs L spousE saCIAL EG
oiiriCE usE oNIY <
D"ATE RECEIVE J(ci (� - CASfI �.C�"�F' �'. RECENED:IiY j7��—