HomeMy WebLinkAboutUtility Company ApprovalWATER
.SEWER
METER'SZ.
Comm
RES NAME
ACCT.
IRR
00- 119 SECURITY",DEP
SERVICETEE
SAME: DAY-FEF
OVERTIME FEE
L13 V. QV
'METER-INSTAL-
39772 10,
CFQ/WATER
FRIJA CFC
(-Was-, 0 L CFQ/SEWER
'GUAR-. REV.,
LATERAL
TOTAL
I�i
ST LUCIE COUNTY WATER & SEWERDISTRICT (SLCU)
SERVICE ADDRESS.
CU ;NEW . .-STOMERAPIPLICATION
m
SUBDIV[SION-Z(-)A,4,al*/-2-el LOT BLOCK V
BILLING
lz
EMAIL ADDRESS:;
PHONE 4f MOVEJN/CLOSING DATE�__.
This application hereby requests and authorizes the Utilityt6 rendervater and/or sewage disposal
sere c. estathe- premises
i ises described above: In accordance: with -the Utilities present, -or -future rges,rules and
regulations, which yrefpr-ence.are rn adea part of this contract: Applicant agrees to pay Utility p
rohiptlyfor
such services inaccordance-with' the established rules7.-and
CUSTOMERS DEPOSITS ARE NON NEGQTIAB,LE-IOR TRANSFERABLE.
APPLICANT AGREES THAT APPLICANT WILL: BEGIN PAYING BASE. FACILITY CHARGES FOR THE UTHXff SERVICE
APPLIED FOR ON THE DAY THE WATER -METER. OR, OTHER UTILZITSERVICE CONNECTION IS INSTALLED AT
APPLICANT'S ,PROPERTY, 1EGARDL REGARDLESS UTILIZING THE ,'-
METER AND/OR URVICE.
OFFICE LISE,ONLY
DATE --RECEIVED 'CASH
CHECK #.r�73 RECEIVED BY