HomeMy WebLinkAboutUtility Company Approval.. .... .... ...................... .................. .................. ........... .............. ................................................. ................................ ..... ... _....._........--..._....._._.......... ......... ......... ....... ..................... ............_...... .......... ............ ._.............................._................... ................................ ...... ........ ... .. .
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ATER 10MM
SEWER ✓ RES-.
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SECURITY DEP
SERVICE FEE
SAME.DAY FEE
OVERTIME FEE
METER INSTAL .
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ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION o��l����
NAME t�d
ACCT. # f `7` - I v� a
Q SERVICE ADDRESS
Fort Pierce, FL 34945
SUBDIVISION LOT BLOCK
BIWNGADDRESS �& t.UL/I�Lie- llrC %V�
EMAILADDDRlss . DMPARRINO�ODRHORTON.COM
13.116NE.4%)J � / MOVE IN/CLOSING DATE
This application hereby requests and authorizes the Utility to 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. Applicantagrees to pay Utility promptly for.
such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR.TRANSFEMBLE.
ANT AGREES THAT: APPLICANT VVU . BEGIN PAYING BASE FACiGI'.TY CHARGES FOR TEE UIIL= SERVICE .
1 j APPL= FOR ON THE DAY TEM WATER METER OR, OTHER .UTILrI Y SERVICE COM ECTION IS INSTALLED AT
—J ..APPi,ICANT'S PROPERTY, REGARDLESS OF WEIEN APPLICANT STARTS UtML15U LTG THE NMTER AND/OR SERVICE.
CUSTOMER SIGNATURE Z�)SOCIAL SEC/FED Ip
NAME OF SPOUSE SPOUSE SOCIAL
OFFICE:USE:ONLY G�
DATE-RECEIVED-1 LAC CASHr RECEIVED SY
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