HomeMy WebLinkAboutWater & Sewer Applicationr/ WATER
SEWER
METER SZ.
t rC-0 Lee ST LUCIE COUNTY WATER& SEWER DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
COMM
RES
M/F
/� . IRR
SECURITYDEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
!�X,3q1 Qt) METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ ��� TOTAL
ACCT. #- 15,nl'
01
SERVICE ADDRESS N O/
J4
SUBDIVISION
BILLING ADDRESS 7GL+
EMAIL ADDRESS:
r
LOT4�BLOCK I
PHONE #7 0� f �cJ T MOVE,IN/CLOSING DA'
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 UIUM SERVICE
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UIUM SERVICE CONNECTION IS INSTALLED AT
APPLICANT'S PROPERTY, REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE.
OFFICE USMNLY
CASH CHECK DATE RECEIVED �Q �--1 it C7� �� RECEIVED BY N<G��