HomeMy WebLinkAboutUtility Company ApprovalV - WATER
SEWER
METER SZ.
COMM
RES
M/F
I RR
t?d
5 SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
'T✓T�_DQ METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV..
LATERAL
TOTAL
ST LUCIE COUNTY WATERA:SEWER: DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
ACCT. # 155V0( - 3 3.) a
SERVICE ADDRESS 5 3'7 9 L U* - G
LOT__ ��/ BLOCK _
BILLING
EMAIL ADDRESS:
PHONE #Yd5(y " ll 3? L/ MOVE IN/CLOSING DATE
This application hereby requests and.authorizes the .Utility,to render-waterand/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 ofthis 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.
APPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY ;CHARGES FOR TBE UI XIy SERVICE
APPLIED FOR ON THE DAY THE WATER NMTER OR UTTER VIII,TIY SERVICE. CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY; REGARDLESS OF WREN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER -SIGNATURE
NAME OF SPOUSE
SOCIAL SEC/.FED-I
SPOUSE SOCIAL
OFFICE USE ONLY
DATE RECEIVED CASH ff-Z-_ RECEIVED BY