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WATER COMM ST. LUCIE COUNTY UTILITIES P.O. BOX 728, FT. PIERCE, FL 34982 SEWER RES NAME METER SZ. M/F ACCT.# l �� IRR SECURITY DEP SERVICE ADDRESS !! ?Z SERVICE FEE Fl, Aerce— SAME DAY FEE SUBDIVISION 7/10t e&,n AVe-4- Lb^t& � LOT Q 01 So BLOCK_f OVERTIME FEE Q /J METER INSTAL BILLING ADDRESS I$ 0, "C©�C 122 0•5 �� 1f"r e�'�e4 r CFC/WATER EMAIL ADDRESS: e d ,51)7 r 16e 6 � &mgI? La )v, FPUA CFC PHONE#�l a D - '3 MOVE IN/CLOSING DATE CFC/SEWER 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, LATERAL rules and regulations, which by reference are made a part of this contract.Applicant agrees to pay TOTAL Utility promptly for such services in accordance with the established rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. CUSTOMER e SIGNATURE SOCIAL SEC/FED ID NAME OF SPOUSE SPOUSE SOCIAL SEC. OFFICE USE ONLY DATE RECEIVED 90 CASH CHK# ���� RECEIVED BY