HomeMy WebLinkAboutSLC Utilities ReceiptWATER Comm
SEWER ,4_ RES
8 METER SZ. M/F
IRR
SECURIT•1' DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL.'
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR REV.
LATERAL
5 —.I C s pp TOTAL
ST. LUCIE COUNT'
N
ACCT. #
SERVICE ADDRESS
PHONE #
RECE
: 728 FT. PIE AFL2
ut
./lam
"j, Q
IN/CLOSING DATE
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,
vles and regulations, which by reference are made a part of this contract. Applicant agrees to pay
Ile Utility promptly for such services in accordance with the established rules and regulations.
,USTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SOCIAL SEC/ r ' FED ID 17�9—
NAME OF SPOUSE SPOUSE SOCIAL SEC. I----
OFFICE USE ONLY