HomeMy WebLinkAboutUtility Company ApprovalN/ SEWER
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ST LUCIE COUNTYWATER.& SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
SERVICE ADDRESS
Fort Pierce, FL. 34945
SUBDNISIONf'�%D1 LOT BLOCK'
BILLING ADDRESS11 /vex UC
EMAIL ADDRESS:�IDNIPARRIN00—DRHORTON.COM
PHONE O�� u/-3_ 9? / i;Z MOVE IN/CLOSING DATE
This application hereby requests and authorizes the Utilltyto render water and/orsewage 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. Applicantagreesto pay Utility promptly for
such services In accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
--APPLICANT AGRKES THAT APPLICANT WILL BEGIN PAYING. BASE FACH UY CHARGES FOR THE UTILITY SER` I `+
AppL= FOR ON TTiE DAY THE WATER METER OR OTHER UTILITY SERVICE CONNECTION IS -INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS iT M ZING THE METER ANDIOR SERVICE.
CUSTOMER SIGNATURE 7577 �r.� SOCIAL SECJFED lD —
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY
SATE RECEIVED �' �q CASH � RECEIVED BY�