HomeMy WebLinkAboutWATER-SEWER-CUSTOMER APPLICATIONr% WATER
SEWER
METER SZ.
t ry,l! CU �� ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
COMM
RES NAM
M/F
IRR
$ SECURITY DEP
r
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
QQ METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV
LATERAL
TOTAL
NEW CUSTOMER APPLICATION
ACCT. # /5 T'O� — 33�(p
SERVICE
SUBDIVISIO
BILLING AD
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3 qqS-7
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LOT (-OS;-
BLOCK I
EMAIL ADDRESS:
PHONE #005 61F�C-3 T 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. Applicant agrees to pay Utility promptly for
such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
FTAPPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY CHARGES FOR THE Lrr MITY SERVICE
APPLIED FOR. ON THE DAY THE WATER METER OR OTHER UIH.dTY SERVICE . CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
OFFICE USE ONLY p f
DATE RECEIVED%�W • �I CASH CHECK # 710� RECEIVED BY