HomeMy WebLinkAboutUtility Company ApprovalWATER.
SEWER
METER�SZ.
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COMM
�RES NAME__6'
— ;M/F I ACCT
IRR,
00 9 SECURITY DEP
SERVICE FEE
SAME DAY FEE-.
OVERTIMEFFE�
Z13 V, 0 d METER -INSTAL.
2,73 q o CF(/WATER
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MER
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f CFC15EWER
GUAR. REV.
'LATERAL
TOTAL
SERVICE
ST'LUCIE COUNTY WATER & SEWER DISTRICT-(SLCU)'
NEW CUSTOMER APPLICATION
11
SD
SUBDIVISION j�� 'LOT
L_19 BLOCK-3
19
EMAIL ADDRES&
PHONE 9. 19jQS7- 5" L/
'MOVE: IN/tLOSING DATE
Is
This application her6by.,req.u,estsand :authorizesth.-e., IUtilitytorender-waterandlor,sewagedispos
al
services to the premises described ted ab—ve. in accordancewih-th
Utilities:Ptese-n't:6r:future rates, rules. and
' of
9julatI , ionswh�6h b�. refetencewe made a part -this..
re cORtract. Applica nt:agtees to. pay-'UtilitY Prom pfly for
such services in --.accordance w t
0th-he
-e lish.ed:rul.e.s 9.
and re ulaticins.
CUSTOMERS. DEPOSITSARE NON N EGOTIABIE-01170AI\18PFRABLE.
APPLICANT AGREES THAT APPLICANT _V011, -BEGIN PAYING BASE -FACILIT . Y CHARGES FOR THE.
ii�iEi - UTffM:SERVTCF,
APPLIED FOR ON THE DAY THE - NATFR OR OTHER ITMny $gg" CONNECTION IS,]INSTALLEDAT
APPLICANT'S PROPERTY,, REGARDLESS OF VVMNAPF!T�!STARTS"U_TJLIZAN.G THE M'
T1RAND/oRsFRvjcF,.
NAME'OPSPOUSE:
SPOUSE.SiOCIAL
OFFICE USE ONLY
DATE'RECEIVED CASH
CHECk-.# R - ECEIVED BY 0