HomeMy WebLinkAboutUTILITY NEW CUSTOMER APPLICATIONWATER COMM
SEWER RES-
METER SZ. M/F.
IRR
SECLIKITY'DEP
SERVICETEE
SAME :DAY PEE
OVERTIME FEE
.
INSTAL
-CF.C/WATER
FPUA CFC
,3t ,c haS-.00, CFC/SEWER-
GUAR. .'REV.
LATERAL
TOTAL
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU.),
NEW"CUSTOMER APPLICATION
-.3 SUtDIVISION LOT Q BLOCK
-
EMAIL ADDRESS..
PHONE-9 9459154? V MOVE IN/jC.L0SINGDATk_
Thls,,appli,cation hereibyrequgstvand authorke5i the Litility..to ron0erwatet:and/orsewago-di.spt)saI
serViceslo the prenises-.describedabove in accordancewith-the Utilitiesaprew.ntor future rates, rules and
regulatlons; which byref6rence,are.madbz part-ofthis ,contract. Applicant :agrees to pay UtIlIty promptly.for
such services Inaccordance withthe established rules and regulations.
lom
CUSTOMERSPEPOSITS'ARE NONiNEGOTIA'i.LE'Ok,.TRANSFERABLE.,
APPLICANT AGREES THAT APPLICANT WILL BEGIN, PAYING BASE FACILITY CHARGES FOR THE UT=Y SERVICE.
APPLIED FOR ON THE: DAY THE WATER NXTER OR OTHER UTH=;S,ERVICE, CONNECTION 18INSTALLED AT
,APP.LIC,A"S'rR,QP,ERTY,REGARDLESS. :01"VAU,NAPPLICANT. STARTS,U,TILVM. G-.THZNMTER AND/OR SERVICE.
H
NAMEOFSPOUSE SPOUSESOCIAL
_
'DATE RECEIVED CASH CHECK#.A7 -Z RECEIVED BY :4
all