HomeMy WebLinkAboutUtility Company ApprovalYA
N 1-W-;wW
ATER
omm
SEWER
✓ RES.
. 5 METER SZ.
M/F
IRR
$ � ` -
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE :I
METER INSTAL
CFC/WATER.
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
/ f1%- 1 TOTAL
ST LUCIE COUNTY WATER &SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
ACCT. #
SERVICE ADDRESS
Fort Pierce, FL 34945
SUBDNISIONC�lD� LOT
BILWNGADDRESS �d 110f- 2%.-C AC
EMAILADDRESS: DMPARRINO@DRHORTON.COM
PHONES / 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. Applicantagreesto pay Utility promptly for
such services in accordance with the established: rules and: regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR. TRANSFERABLE.
a'APPLICANT AGREES THAT APPLICANT WILL BEGIN- PAYING BASE FACILITY CHARGES FOR TITS UIRM- SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UTTL1'i'Sr SERVICE - CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE 224;1-141. CAAZ;Z69 SOCIALSEC/FED ID. '-
NAME OF SPOUSE
SPOUSE SOCIAL -
OFFICE :LISE ONLY
DATE -RECEIVED CASH CHECK #' RECEIVED BY