HomeMy WebLinkAboutUtility Company Approval4 WATER
X SEWER
METER 5Z.
COMM
RES NAMI
WF ACCT.
IRR
�a;y_ 9 SECURITY DEP
SERVICE FEE
.SAME DAY- FEE
OVERTIME- FEE
113 (J
METER INSTAL
31273 - 0 0
CFQ/WATER
_FRUA,.CFC
CFC/SEWER
GUAR. REV.
LATERAL
_J7 TOTAL
ST LUCff COUNTY WATER SEWER: DISTRICT (SLCU)
NEW CUSTOMER _' APPLICATION
SUBDIVISIO
LOT BLOCK 3
BILLING ADDRESS �.do
EMAILADDRESS:
PHONE MOVE IN/CLOSING : DATE
This -application" hereby b..y.'requests,and'EuthQfizes,,'the. Utility to,t6nder water -a d./orsewagIejmsposa
services tothelpremises -described above- In accordance Wktht present Or future rates; :ru rules. 'and'
regulations, -whit h'b" -f 'contract. to.pay utility pr mpti , r
.,..,y.,reerenc,eEir.ema,d,iE�Opart,,,ofthis, Applicant o yfb.
st4gh,sqvicesIn accordance With the established rules:and regulati
ons.
Cw.0mER5 DEPOSITS ARE NON„NE.GOTtAgLE---OkTRANSFERABLE.
APPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY -CHARGESFOR THE -
APPLIED FOR ON THE DAY THE WATER AMTER OR ,OTHER UTILITY SERVICE: F .. UT91w SERVICE
C01*MCT,10N IS INSTALLED' AT.
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APP1JQANTSTART&UM"1(NQ THE' METIE ' R AND/QR SERVICE.
SIGNATURE
SO IALSECIPED:ID'
NAMEMSPOUSE
SPOUSE: SOCIAL
OFFICE: USE
DATE -RECEIVED- CASH CHECKA RECEIVED BY