HomeMy WebLinkAboutUtility Company ApprovalWATER
1- SEWER
5g METER SZ.
COMM
RES
M/F
IRR
$ 01, SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
` ,31f, METER INSTAL
317 -73_ UQ CFC/WATER
FPUA CFC
CFC/SEWER
Ole_
GUAR. REV.
/f LATERAL
�;; ., $ l �• �} TOTAL
ST LUCIE. COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
69-
ACCT. # IS 5 VQ ! 0 4-5
SUBDIVISION __ f�i�l2� LOT ,3 BLOCK
BILLING ADDRESS
EMAIL ADDRESS:
o
PHONE # 905
— 0 � MOVE IN/CLOSING DATE
F cQ!�3,3
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.
APPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY CHARGES FOR THE UT = SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UTI= SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE SOCIAL SEC/FED ID
NAME OF SPOUSE
SPOUSE SOCIAL
OFFICE USE ONLY
DATE RECEIVED CASH CHECK # RECEIVED BY