HomeMy WebLinkAboutUtility Company ApprovalTER
Y SEWER
METER SZ.
Lt!
OMM
RES NAME
M/F
iRR
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
,r� n LATERAL
TOTAL
ACCT.
ST LUCIE COUNTY WATER& SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
?Of T V
00
SERVICE ADDRESS2-
Fort Pierce, FL 34945
SUBDIVISION��D� d� LOT BLOCK
BILLING
EMAILADDRESS: DMPAR/RIINO _DRHORTON.COM
PHONE #�� JJ ! �.�a'+ 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. Applicant agrees to pay Utility promptly for
such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
El'APPLICANT AGREES THAT APPLICANT WILL. BEGIN .PAYING BASE FACILITY CHARGES FOR THE UTHITY SERVICE
. APPLO D FOR ON THE DAY THE WATER METER OR OTHER UTILITY. SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WE EN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE TJura dAhziw SOCIAL SEC/FED ID
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY
DATE -RECEIVED CASH CHECK # RECEIVED BY