HomeMy WebLinkAboutSLC Utilities ReceiptWATER
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SEWER K RES
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GUAR. REV.
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CUSTOMER
SIGNATURE
NAMEOF
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ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE FL 34982
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This application ereby request and authorizes the Utility to re der wa r and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
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.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/
FED ID
SPOUSE SOCIAL SEC.
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DATE RECEIVED/ /1?'' OFFICE USE ONLY
ab CASH CHK # �7// // RECEIVED BY