HomeMy WebLinkAboutUtility Company ApprovalTLUrC-Ee
V *TER OMM
SEWER t/ RES
METER SZ. M/F
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SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
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TOTAL
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
NAME
ACCT. # 188V5
SERVICE ADDRESS
Fort Pierce, FL 34945
SUBDNISIONeG'`�'/Q67 411�-7 LOT f L U BLOCK
BILLING
IJ6
EMAILADDDREss: �D%MPARRINNO_c@-DDRHORTON.COM
PHONE,O j) t3-3J 9 / / ,;� 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.
'APPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY CHARGES FOR THE UTffffY SERVICE
APPLm FOR ON THE DAY THE WATER METER OR OTHER UTILITY SERVICE CONNECTION S,S INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE MMTERAND/OR SERVICE.
CUSTOMERSIGNATURE Z 0ri CAZote SOCIAL SEC/FED ID
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY
DATERECEIVED CASH CHECK
RECEIVED BY