HomeMy WebLinkAboutUtility Company ApprovalY SEWER
METER SZ.
4�1
01,111mom-
�MM
RES
M/F
0-5.
IRR
$ 0
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ 1 / TOTAL
ST LUCIE COUNTY WATER& SEWER DISTRICT (SLCU)
NAME
NEW CUSTOMER APPLICATION
I-C`6AJ
ACCT. # !U 7U
SERVICE ADD
Fort'Piierce, FL 34945
SUBDIVISIONeXEZ Zy"0&7 4 LOT C� BLOCK 1
BILLING
A� -61�1' /-Z13 Q 9Z) 9
£MAILADDRESS: DMPARRINO@DRHORTON.COM .
PHONE � [cal f / 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.
E] APPLICANT AGREES THAT APPLICANT WILL BEGIN. PAYING: BASE FACILITY CHARGES FOR THE UTHM SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR .OTHER UTILITY SERVICE CONNECTION IS INSTALLED AT
.APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILE ING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE Z2i;Z4, Q/LllaL9 SOCIAL SEC/FED-ID —
NAME OF SPOUSE
SPOUSE SOCIAL•
OFFICE USE ONLY
DATE -RECEIVED CASH CHECK # RECEIVED BY