HomeMy WebLinkAboutUtility Company ApprovalV SEWER
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M/F
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SERVICE FEE.
SAME:DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ TOTAL
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
ACCT. # S `� l� 17a 16
SERVICE ADDRESS `fD F�JI�S"T
Fort Pierce, FL 34945
SUBDIVISIOj8eZ /,0&7 LOT BLOCK
-BILLING
,V, -5 IJ6 A&yt
EMAILADDDRESS:. 1DMPAR/RIINO DRHORTON.COM
PHONE #q �) lcJf (� 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 promptlyfor
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 THE UTILITY SERVICE
APPLW) .FOR ON THE DAY THE WATER METER OR OTHER UMM SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WEMN APPLICANT STARTS UTII,IZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE T»tat� a�it. SOCIAL SEC/FED ID
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY
DATE -RECEIVED 3' i `- •A CASH _ RECEIVED BY