HomeMy WebLinkAboutWATER & SEWAGE APPLICATIONWATER
SEWER.
METER SZ_
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11?9 SECURITY DEP
SERVICE FEE.,
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OVERTIME FEE
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CFC/SEWER.
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LATERAL
TOTAL,
ST LUCIE COUNTY WATER & SEWERDISTRICT (SLCU)
NEW CUSTOMER APPLICATION
NAME
ACCT.
SUBDIVISION:
LOT
BILLING:
'EMAIL ADDRES
PHONE:#. w 3 MOVEIN/CLOS IN/CLOSING
_ I . DATE
Thisapplication.bereby requestsand authot�izes,,th-e�Utlity-tor.enderwatL-r,an4/prs.ewage.,,qispo sewage -;disposal
.
Spr'Vj� �p$:to_"%fjoPrpmjtpsT sE11
.,doscfibed -a bO'Ve,in..Oct(jtd.o.nce,,wi.th the- Utilitibs:pretent or -future ratesi rules, and,
reg
ulations,.whicl b*rdfe'rd reference n are * _. - Made a Ort-6fthis contract. ,Appk ntag- � sto-,p
such.s6rvi' co 6 . ree� _8y Utility., promptlyfor
cps in accordance the 0 a lished'-f 16
st,,b
u - 5 and &I
CUSTOM _ regulations.
'.
CUSTOMERS DEPOSITSARE NON NEGOTIABLE OR TRANSFERABLE.,
APPLICANT AGREES THAT APPLICANT WILL, . BEGIN- PAYING BASE FACILITY CHARGES, FOR THE UMITy SERVICE
EA C.'.,ftMON IS INSTALL'ED AT
AI?FL�ED FOR I-QN THE DAY- THE WATER METER OR: OTHER VrH -, n:$ 0
y
APPLICADWSTROPERTY, REGARDLESS- OF, WEIENAPiLICANT-STARTS UTILIZING THE METER A-ND/OR SERVICE.
E
NAME OF SPOUSE
SPOUSE SOCIAL
OFOCE..ust ONLY
DATE RECEIVED
CASH CHECK #' R757/"7
RECEIVE6 BY