HomeMy WebLinkAboutPSL Utility Service ApplicationCITY OF PORT ST. LUCIE UTILITY SYSTEMS DEPARTMENT
NEW RESIDENTIAL SERVICE APPLICATION
NEW CONSTRUCTION
Account Name: PORT ST LUCIE PROPERTIES INC
Service Address; ,=m13S 25TH�STF3EFT
City: FORT PIERCE State: FL Zjq; 34981
Mailing Address: 201 SW PORT ST LUCIE BOULEVARD STE 103 PORT ST
LUCIE FL 34984
Primary Phone #: (772) 626-3176 Secondary Phone#: (772) 249-0086
I.D. # ******7111
Legal Description:' SEC 5 TWP 36 SOUTH RANGE 40 EAST
Cycle: 02 Book: 500
Zone: NON
Plant:
0814135 - 833361
Customer - Account
WATER Capacity: (One ERC): $ 1,423.00
NON SAD/USA Line Fee: $ 734.00
SAD/USA %" Meter Fee: $
NON SAD/USA %" Meter Fee: $ 640.00
TOTAL WATER: $ 2,797.00
SEWER Capacity: (One ERC):. $
NON SAD/USA Line Fee:
$
Grinder Installation:
$
LPS Installation Fee:
$
Septic Service:
$
Gravity Sewer:
TOTAL SEWER:
$
Security Deposit Water: $ 50.00
Security Deposit Sewer: $
Recording Fee: $
LESS DEPOSIT& RECORDING $
TOTAL AMOUNT DUE: $ 2,847.00
❑ Cash NliCreclitCarcl ❑ Check #
RECEIPT#: DATE PAID: 04/29/2021 BY: MBATTAGLIA
ITILITY will provide water and/or sewer service upon payment of the applicable connection charges and compliance with the Terms and Conditions listed on the back of this Service Application. The Utility policies provide for a water
nd /or wastewater plant capacity allocation of two hundred and fifty (250) gallons per day equivalent residential connection (ERC). The Utility will not be obligated to provide capacity of service in excess of the allocation and may
squire consumer to curtail use which exceeds such allocated capacity. I have read and -acknowledge receipt of this Service Agreement by signature below.
psi prop inc K.M.
04/29/21
CUSTOMER'S SIGNATURE
DATE