HomeMy WebLinkAboutSLC Utilities Receipt+l__ WATER ;OMM
SEWER _ RES
METER SZ. M/F
9 �� IRR
$ SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE'
) METER INSTALL.'
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
` TOTAL
CUSTOMER
NAME OF SPOUSE
ST. LUCIE C TY UTILI S _ <6X 728 F . PIERCEj`' FL 34982
NAMEY��s
ACCT. # _�j L/
SERVICE ADDRESS
ASUBDIVISION LOT /,-), BLOCK -�
BILLING ADDRESS %�
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—MOVE /CLOSING D�AL�TE�J
CAVA1ON
This application hereby request Turiie �S'
Utility to render water 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 5�O 3Db6l & y
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
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