HomeMy WebLinkAboutUtility Company ApprovalWATER COMM
SEINER RES
METERSZ.. lVi/F
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$ SECURITY:DEP
_ SERVICE" FEE
SAME DAY FEE
OVERTIMETEE
7-0
0 'METER INSTAL
CFgWATER
FPUA CFC
CFC/SEWER
GUAR: REV.
LATERAL
TOTAL
ST 'LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
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ACCT.
SUBDIVISION- LOT. BLOCK_
BILLING AD
EMAIL ADDRESS:
PHONE'#D5 'J9 7 MOVE.IN/CLOSING DATE
This applicatiomhereby requests' and authorizes the'Utilifyto render water and/or sewage ,disposal.
services *to the: premises:described above. in- accordance' With the. Utilities; present or future. rates _rules` and
regulations,,whichbyreference are made a part of this contract. Applicant=agrees to imV�Utility- promptiv.for,
such services,in accordame.with the established.rules and regulations:
CUST,OMERS`DEPOSITS=ARE NONNEGOTIABLE .0117 ANSFERABLES
APPLICANT AGREES THAT APPLICANT? WILL BEGIN PAYING BASE FACILITY CHARGESFOR THE UTHITY SERVICE
APPLIED` FOR -ON THE DAY THE. WATER METER OR OTTER UTILITY SERVICE. CONNECTION Is INSTALLED AT
APPLICANT'S. PROPERTY, REGARDLESS OF'WHEN APPLICANT; STARTS THE METERAND/OR'SERVICE.
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NAME OF SPOUSE
SPOLISE;SOCIAL..
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DATERECEIVET) .f _�- - CASH CHECK fk- _ RECEIVED'BY