HomeMy WebLinkAboututility receipt 116-5Cfai
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WATER COMM
SEWER RES
5 METER SZ. M/F
IRR
$
SECURITY aEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
�. QQ METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
TOTAL
NAM
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
FiI4LTM40ki(011114 ZJ
ACCT. # 1 .59( a W -! 5_
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SUBDIVISION _.... LOT BLOCK_�,,�
BILLING
EMAIL ADDRESS:
PHONE # !?05" 0 32 !1 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 TM UTffX Y SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UTUITY SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGALESS OF WREN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE
NAME OF SPOUSE
SOCIAL SEC FE
SPOUSE SOCIAL
OFFICE USE ONLY
DATE RECEIVED �. _ _ _ CASH CHECK # OW6 1P T RECEIVED BY