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HomeMy WebLinkAboutMisc LettersX WATER COMM SEWER RES METER SZ. M/F IRR $ SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE METER INSTAL CFC/WATER FPUA CFC CFC/SEWER GUAR. REV. LATERAL $ TOTAL ST. LUCIE COUNTY UTILITIES - P.O.004 728, FT. PIERCE, FL 34982 NAMEGregory'Scott Wilken and Patricia Wilken ACCT. # i t SERVICEADDREss6017 Buchanan Drive, Fort Pierce, FL 34982 SUBDIVISION Indian River Estates LOT67, 68 & BLOCK6 BILLING ADDRESs601 7 Buchanan Drive, Fort Pierce, FL 34982 EMAIL ADDRESS: Dwilkenpgunster.com PHONE # 772-528-8274 MOVE IN/CLOSING DATE 1996 This application hereby request 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. CUSTOMER SIGNATURE SOCIAL SEC/FED ID 266"47-7577 NAME OF SPOUSE atri id U Cen SPOUSE SOCIAL SEC. 047-60-4178 OFFICE U�E ONLY I E. -� DATE RECEIVED_ 2 CASH CHK # RECEIVED BY