HomeMy WebLinkAboutUTILITY SERVICE APPLICATION CITY OF PORT ST. LUCIE UTILITY SYSTEMS DEPARTMENT
NEW RESIDENTIAL SERVICE APPLICATION
NEW CONSTRUCTION 0814135 - 835205
Customer-Account
WATER Capacity: (One ERC): $ 1,423.00
Account Name: PORT ST LUCIE PROPERTIES INC NON SAD/USA Line Fee: $ 734.00
Service Address: 2205 RIVER HAMMOCK LANE SAD/USA%" Meter Fee: $
NON SAD/USA%" Meter Fee: $ 640.00
City: FORT PIERCE State: FL Zip'. 34983 TOTAL WATER: $ 2,797.00
Mailing Address: 201 SW PORT ST LUCIE BOULEVARD STE 103 PORT ST SEWER Capacity: (One ERC): $
LUCIE FL 34984 NON SAD/USA Line Fee: $
Grinder Installation: $
Primary Phone#: (772) 626-3176 Secondary Phone#: (772) 249-0086 LPS Installation Fee: $
I.D. # ******7111 Septic Service: $
Gravity Sewer: ❑
TOTAL SEWER: $
Security Deposit Water: $ 50.00
Security Deposit Sewer: $
Legal Description: LOT 10 BLK 23-2 PARCEL C RIVER HAMMOCK Recording Fee: $
CYCIe: 02 Book: 500 LESS DEPOSIT& RECORDING $
Zone: NON TOTAL AMOUNT DUE: $ 2,847.00
Plant: []Cash ■ CreditCard ❑Check#
RECEIPT#: DATE PAID: 08/06/2021 BY: MBYRD
UTILITY will provide water and/or sewer service upon payment of the applicable connection charges and compliance with the Terms and Conditions listed on the back of this Service Application.The Utility policies provide for a water
and/or wastewater plant capacity allocation of two hundred and fifty(250)gallons per day equivalent residential connection(ERC).The Utility will not be obligated to provide capacity of service in excess of the allocation and may
require consumer to curtail use which exceeds such allocated capacity.I have read and acknowledge receipt of this Service Agreement by signature below.
Kristen Montalto 08/06/21
CUSTOMER'S SIGNATURE DATE