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HomeMy WebLinkAboutUtility Company Approval.h llL ST ;LUCIE NE VIlATER :COMM �C.: ;SEWER B'ES` METER:SZ. 1RR poa- -, 2n -I SECURTTY`D -P SERWCEKE SAME DAY EEE 'OVERTINIE FEE 'T`#•: 'METEI2INSTAL CKMATER FPUA CFG CFOEWER, GUAR ,REV;, LATERAL TOTAL: APPLICANT AGREES: APPLIM FOR ON 3 APPLICANT'S PROPS] WATE.R'.& KW- ER-DISTRLCT (SLCU) %kP P L I CATION; SEWCE ADDRESS: ✓ � GU ... ' "'� ..3 ' $UBDIVISION_ LOTc�'.,_::. BLOCK. . _twn��,nvvnr�x- . PNDIVE# �5,� +! 7 MOVE 1N/CL'OSIN, tOATE. Ths:applreation'herebyreguestsandauthorizesthe Utility to;renderwaterand/orsewage_dsposal services toahe premses:de§cribed above in:accordanee'withatie Utilities present orture rates, rules and. regulations, which by reference are made_ a part:of this.coritract Appfieant:agrees to pay Utility :promptlyfor such<services m•accordance with:ihe established.ruI, and.reguiations , CUSTOMERS DEPOSITS AREA NONAE' IABLE OR TRANSFERABLE:: APPLICANT WILL BEGIN PAYIlYG': BASE FAGI'1'Y :CHARGES F.OR.;TTII.ITYSERYXCE: r - ' THE WATER METER. OR: _OTHER U'T�LIT°Y:SERVICE CUNNECTION IS 'INSTAGLED.:AT �GARDLE$S: OF WAEi�T'APPLICA�NT�STARTS U�'ILiZIN.GTHE=METERA,NDJOR:SERVIC`E . �x w.. .rw • • .wow fr�w..w .� /. � 1,/.i.. NAME QF SMUSE :SROUSESOCIAI : ,OFE U_SE ICE ONLY DATE: RECEIVED: '' t _ _ CAS H CHECK lt4�aD RECEIVE BY ,