HomeMy WebLinkAboutUtility Company ApprovalTER
SEWER
METER SZ.
_MM
RES
M/F
IRR
$
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV
LATERAL
fz
/ i TOTAL
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
,, D/ 4 //,0 0-7-0 A J
ACCT. # / U V U — 9CQ,5_3_
SERVICE
331
Fort Pierce, FL 34945 U L
SUBDIVISIOJ - LOT / BLOCK
BILLING 1 ADDRESS (.w/V��— cLJ%Z6UG /tiU A2 a 94 / �
EMAILADDDREss: �DJMPAR/RIINN0 DRHORTON.COM
PHONE d4—w r l 7 MOVE IN/CLOSING DATE
This application hereby requests and authorizes the Utilityto render water and/or sewage 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. Applicant agrees to pay Utility, promptly for
such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
ElAPPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY CHARGES FOR TBE UTELXTX SERVICE
* APPLXD FOR ON THE DAY THE WATER METER OR OTHER UTff= SERVICE CONNEMON IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE Z2Za��t9 SOCIAL SEC/FED ID —
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY /.
DATE RECEIVED q-U--2,e) CASH E *a( # ! RECEIVED BY