HomeMy WebLinkAboutUtility Company ApprovalWATER
SEWER
comm.
RES,
METER SZ.
M/F'
d
IRR,
S76D d 1"?9 0
SECORITY'DEP
SERVICE FEE
_SAME DAY FEE
OVERTIME_- FEE
'ko( j
M U, ER- INSTAL
IJ D
CFC/WATER
FPUA.CFC.
0.0
CFC/SIEWER
GUAR; REV..
LATERAL
TOTAL
I.,
r:t 0-
ACCT.
SERVICE ADDR
ST LUCIE COUNTY WATER -& SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
V.? ---;-
.9
SUBDIVISI0,N
LOT -
BLOCK
BILLING ADDRESS: <-73QPd_J0
EMAIL ADDRESS:
-PHONE# "2mS— MOVE IN/CLOSING DATE
-------------
This:ap.01ie;pt!Oh:het6b.y:re.ques.ts'and au.thorizesthe Utility -to render water -and/or sewagp-disposal;
servims-to,the prgmises;d
espribed,abov in qccordancewithA e Utilities present dr-fLtdrq-r6tes; rules
regulations, which by'referenceand.
are made part tt)Atract.,-Applicantagr!aesto,, ay Utility: promptly for
such services in accordance with the established ruJesan®pIbtions.
CUSTOMERSDEPOSITS. ARE NON NEGOTIABLE 011TRANSFER
ABLE:
APPLICANT AGREES THAT APPLICANT' WILL BEGIN PAYING BASE FACILITY CHARGES FOR THE UUUy SERVICE
APPLIED FOR. .ON THE DAY � THE. WATER, N[ETEk OR OTHER UTILITY SERVICE CONNECTION IS INSTALLED AT
LE
NAME -OF SPOUSE SPOUSESOCIAL
OFFICE USE ONLY
DATE RECEIVED ri - o CASH CHECK # 13 RECEIVED BY &IiMA
),Sg 6