HomeMy WebLinkAboutUtility Company Approval'✓ ATER
MM
SEWER
%.
✓ RES
METER SZ.
MIF
IRR
$
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV,
�} LATERAL
TOTAL
ST LUCIE COUNTY WATER & SEWER D.ISTRICT-(SLCU)
NEW CUSTOMER APPLICATION
a-fz/V
3a� 2
SERVICE ADDRESS
Fort Pierce, FL.34945'
SUBDNISIOJ�'B&7 LOT 9:29 BLOCK
B LLIN DDRESS
I G A
EMAILADDRESs:_ DMPARRINO@DRHORTON.COM
PHONE #� �J �c.�Jf /� / 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-
-APPLICANT AGREES THAT APPLICANT WILL BEGIN. PAYING BASE FACILITY CHARGES FOR THE :UTHM SERVICE
APPIXED . FOR ON THE DAY THE WATER METER. OR: OTHER:.UTff= SERVICE CONNECTION IS .INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTI 17 NG THE METER AND/OR SERVICE.'
CUSTOMER SIGNATURE PdA47ce SOCIALSEC/FED ID
NAME OF SPOUSE
SPOUSESOCIAL-_
OFFICE USE ONLY
DATE -RECEIVED- CASH CHECK# RECEIVED BY:.