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HomeMy WebLinkAboutUtility Company ApprovalWATER SEWER g METER SZ. L;`�,;. ST LUCIE C )UNTY WATER &SEWER DISTRICT (SLCU) NE'W CUSTOMER APPLICATION l' COMM ��- RES M/F IRR r' SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE TA T' METER INSTAL 3173_ 0o CFC/WATER FPUA CFC .(�©. CFC/SEWER co GUAR. REV. LATERAL $ TOTAL ►7T.-I l 1&a441r �Wie-f A, 4, " & er / 'r L- ACCT. # lJ�q� v SERVICE ADDRESS 517c SUBDIVISION {�I�' LOT BLOCK BILLING ADDRESSb� ��P1 EMAIL ADDRESS: PHONE #(�V d T 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 TBE UTH117Y SERVICE APPLIED FOR ON THE DAY TIN WATER METER OR OTHER UTQ.,TTY SERVICE CONNECTION IS INSTALLED AT APPLICANT'S PROPERTY, REGARDLESS OF WMN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE. CUSTOMER SIGNATURE NAME OF SPOUSE SOCIAL SEWED ID SPOUSE SOCIAL OFFICE USE ONLYa ?oe/ DATE RECEIVED l(1 CASH CHECK # RECEIVED BY