HomeMy WebLinkAboutUtility Company ApprovalY SEWER
S METER SZ..
MM
RES:
M/F
IRR
SECURITY DEP
SERVICE FEE'
SAME DAY FEE
OVERTIME FEE
METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. -REV.
LATERAL
$ / / i TOTAL
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
NAME
ACCT. ## /99 VU . "r ! 4? /
SERVICE
�a3
1i`7V 6IL
Fort Pierce, FL 34945
SUBDIVISIONO_Ez �'ibc Jj�: LOT <3 / BLOCK
BILLING
uC /vim A&ns ,
EMAiLADDRESS:. �DJMPARRINO@DRHORTON.COM
PHONE` r�J MOVE IN/CLOSING DATE
.311�g109
This application hereby requests and authorizes the Utilityto 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 apart of this contract. Applicant agrees to pay Utility promptlyfor
such services in accordance with the established rules and:regulatlons..
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR.TRANSFERA.BLE.
aAPPLICANT AGREES THAT APPLICANT WILL BEGIN: PAYING BASE FACILITY CHARGES FOR THE:TJIMTY SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UTII.iTY SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE =M7 2titllt9 SOCIAL SEC/FED ID
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE USE ONLY
DATE -RECEIVED CASH CHECK# RECEIVED BY