HomeMy WebLinkAboutProject Information WATER COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728,FT.PIERCE,FL 34982
SEWER RES
NAME �, --« 1- rr�_L
c
METER SZ. M!F ACCT.#
IRR
$ DEP SERVICEA9 DRESS
SERVICE FEE
--.---
SAME DAY FEE f —LOT BLOCK
�..-
�''�, SUBDSUBDIVISIONOVERTIME FEE
/ METERINSTALL.' BILLINGADDRESSLyc-
CFC/WATER
FPUA CFC PHONE :7?2 679 1_24 27_MOVE IN/CLOSING DATE
CFC/SEWER
This application hereby request and authorizes the Utility to render water and/or sewage disposal
GUAR REV. services to ithe 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
the Utility promptly for such services in accordance with the established rules and regulations.
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER ' SOCIAL SEC/
SIGNA u . FED ID I- , ••'-9
NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY A
DATE RECEIVED-�`= = .A CHK# RECEIVED BY
—� J�-T
RECEIVED
S7. 6�a�i`GOunty,Permitting