HomeMy WebLinkAboutUtility Company ApprovalATERMM
SEWER. ✓ KES .
METER SZ. M/F
IRR
$ SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER'INSTAL
CFC/WATER
FP:UA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ TOTAL
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ST LUCIE COUNTY WATER & SEWER DISTRICT:(SLCU)
NEW CUSTOMER APPLICATION
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Fort Pierce, FL 34945
SUBDNISIOJL, lD&7 . . .
BILLING
LOT 3
EMAILADDRESS:�DfMPARRINNO@DRHORTON.COM
PHONE tOQ J) ` J' �! / MOVE IN/CLOSING DATE
BLOCK
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: THE UTILITY SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UMHY SERVICE CONNECTION IS . INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER ANDIOR SERVICE..
CUSTOMERSIGNATURE =077 77777 SOCIAL SEC/FED ID . '
NAME:OF SPOUSE SPOUSE SOCIAL'
OFFICE USE ONLY
DATE -RECEIVED CASH CHECK # RECEIVED BY