HomeMy WebLinkAboutUtility Company Approval -- '�.1 L �;DL � �. ST,WICIy� - UNT1l`VUATE SEWER,DISTRICT'(ShCU)_
NE11/.CUSTO.MER prPPLI.CATIO:N
WATER L Comm �.
'SEWER -RES NAME . eo.
METER SZ. M/F gCGT.# I.Q
.IRR
. oa
$: SECURITY D.EP SERVICE�ADDRESS
SERVICE FEE iT C) I
SAME DAY FEE:,
:SUBDIVISIONWaLuck LOT BLOCK
OVERTIME FEES;
�l f
OC� METER INSTAL BILLING'ADDRES$ ' , 7iu.j- -e2-e, 3,068
CFC/WATER EMAIL ADDRESS:
FPUA CFC' QQ
PHONE#: �. r" 7 MOVE 1N/CLOSING-DATE
CFC/SEWER
GUAR. REV This:application.hereby'requests'antl authorises the'Utility-to render:water-and/orsewage-disposal
servicesto:thepremises:desceibed;above-in,accordance with the Utilitie"s;presentorfuture rates,rulesi;and.
LATERAL- regulations,.which'by:reference are made apart of this contract.Applicant.agrees.to..pay Utility promptlyfor
TOTAL suchaervices:in accordance with`.the established rules and`regulations:
CUSTOMERS DEP.OSITS;ARE;.NON NEGOTIABLE-OR TRANSFERABLE.:
APPLICANT AGREES THAT APPLICANT WILL.BEGIN PAYING: BASE:FA.CILM CHARGES FOR THE UTILITY:SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR, OTHER UT[GITY ,SERVICE CONNECTION IS: INSTALLED AT-
APPLICANT'S PROPERTY;'REGARDLESS.:OF QVHEN APPWCANT'STARTS'UTILIZING THE METER AND/OR SERVICE.
CUSTOM.EKSIGNATURE ;SOCIAL'SEC%FED ID
NAME OF SPOUSE SPO.USE'SO:CIAL
OFFICE-USE ONLY'
DATE.RECEIVED CASH_ CHECK RECEi1/ED.BY