HomeMy WebLinkAboutUtility Company Approval...... ........ ............. ........... _.................................................. ..... _.......................... .,............._.............:
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
�NEW: CUSTOMER APPLICATION
ATER MM
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NAME.
SEWER RES
ACCT.
METER S2. M/F
A,
' ERR
$ 0 SECURITY DEP
SERVICE ADDRESS V lY Z) lkt 4, C—
SERVICE FEE
:Fort Pierce, FL 34945
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SAME: DAY FEE
SUBDIVISION LOT BLOCK::
OVERTIME FEE
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METER INSTAL
BILLING.ADDRESS
CFC/WATER
EMAILADDRESS:.
FPUA CFC
�DMPARRINO@rDRHORTON.COM
PHONE ��� l ,3_ ! 9 / d.. MOVE IN/CLOSING DATE
CFC/SEWER
GUAR. REV.
This application hereby requests and authorizes the Utilityto render water and/orsewage disposal
services to the premises described above in. accordance with the Utilities present or future rates, rules and
n LATER
/
regulations, which by reference are made a partof this contract. Applicant agrees to pay Utility promptly for
such services in accordance with the established rules and regulations.
$ i TOTAL
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
APPLICANT: AGREES THAT APPLICANT VML BEGIN PAYING BASE FACIIITY CHARGES. FOR .THE UTILITX SERVICE -
. APPLIED FOR ON: ITHE DAY THE WATER METER OR OTHER UTILITY SERVICE CONNECTION ]IS: INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WAN APPLICANT STARTS UTH"-JNG THE METER AND/OR SERV.CCE.
CUSTOMER SIGNATURE 7,7d, P,4AilZJZ9 SOCIALSEC/FEDID
NAME OF SPOUSE SPOUSE SOCIAL•
OFFICE USE ONLY
DATE -RECEIVED CASH CHECK # RECEIVED BY