HomeMy WebLinkAboutSLC Utility Receipt l
o I
WATER COMM ST.LUCIE couNTY UTILITIES- .O.BOX? FT.PIERCE FL 349$2
SEWER RES NAME ti 4'yvch
I
E"J METER SZ. M/F ACCT.# �Q
IRR r-
S SECURITY DEP SERVICE ADDRESS .I
— SERVICE FEE
SAME DAY FEE � i V
SUBDIVISION LS-- LOT ;` BLOCK
OVERTIME FEE �_ f
NIETERINSTALL.' BILLIN DRESS L. , ✓ f
CFC/WATER
FPUA CFC PRONE# MOVE INICLOSING DATE
CFCISEWER
GUAR REV This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
Fg� rules and regulations,which by reference are made a part of this contract.Applicant agrees to pay
T- Ni the Utility promptly for such services in accordance with the established rules and rlegulations.
$.^--� t C� TOTAL CUSTOMERS DEPOSITS ARE NODI NEGOTIABLE OR TRANSFERABLE.
I
CUSTOMER - SOCIAL SECJ I{{
FED ID
#'SPOUSE . SPOUSE SOCIAL SEC.
OFFICE USE ONLY
Now
l
'I
i
,II
I
I I
� I