HomeMy WebLinkAboutSLC Water & Sewer Applicationj/ SEWER
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SERVICE
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER -APPLICATION
-- 7Q3
323c2cn")
Fort Pierce, FL 34945 V
SUBDIVISIOJi E* 1toC 42 Y LOT J7'�Z BLOCK
BIWNG
EMAILADDRESS: DMPARRIN00-DRHORTON.COM
PHONE #&O T,3— 9? 2c� MOVE IN/CLOSING DATE
This application hereby requests 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, rules and
regulations, which by reference are made a part of this contract. Applicant agrees to pay Utility promptly for
such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
E] APPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY CHARGES FOR THE UT'HM SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UT'II.,YTY SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WAN APPLICANT STARTS I7'1H MKG THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE SOCIAL SEC/FEl)ID —
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY
DATE -RECEIVED, ���+ CASH -�i�—Adc:,:::: RECEIVED BY !C/`