HomeMy WebLinkAboutUtility Receipt LL ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
' NEW CUSTOMER APPLICATION
St_ Lucie County - PUTIL � lQ�p
1.1 17-2021 09:42:50
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16435/.7.7.41 RECEIVED
HOMECRE&fMES, INC
FORT PIERCE NAME �' - ��S T,� C� 2071
_
34951 Lr 1 + '7 ) St.Lucie County
Amount Tendered: 8,314.00 ACCT.# �, permitting
Amount Paid: 8,314.00 ����
Change Due: 0.00 SERVICE ADDRESS
Thank You
User ID: MURRAYA SUBDIVISION Jdc I"1&f LOT (, BLOCK
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METER INSTAL BILLING ADDRESS_ �I Lo a o u) pe'-�rmP
CFC/WATER EMAIL ADDRESS:_ rnn h QW M aJ1 D rY1 e-C.re-ke-Y LCYVLe S . C 0 IM
l / /� FPUA CFC PHONE# —I 7a-573- � 07 0 -7 MOVE IN/CLOSING DATE
7c D V CFC/SEWER
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agtf GUAR. REV. This application hereby requests and authorizes the Utility to render, water and/or sewage disposal
services to the premises dgscribed above in accordance with the Utilities present or future rates, rules and
/a 7- Cos.T LATERAL regulations,which by reference are made a part of this contract.Applicant agrees to pay Utility promptly for
$ _ OTAL 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 UTHM SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UTILITY SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY,REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
CUSTOMER SIGNATURE SOCIAL SEC/FED I.D rI'7- CO3 q LQ a
NAME OF SPOUSE SPOUSE SOCIAL
!! OFFICE USE ONLY
DATE RECEIVED_.... CASH CHECK# 4S30D- RECEIVED BY