HomeMy WebLinkAboutUtility BillFl WATER
SEWER
MM
V'ES
6 METER SZ.
M/F
IRR
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL.
CFCAVATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
—TOTAL
o 0 2-
ST. LUCIE COUNTY UTILITIES -Jr.v. BOX 728, FT. PIERCE, FL 34982
NAME
ACCT. #
SERVICE ADDRESS
SUBDIVISIONI) LOT BLOCK_
N A .4,
,D�ESS, YAV, BILLINGAD
PHONE # MOVE IN/CLOSING DATE
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
the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SOCIAL SEC/'
SIGNATURE FED ID
NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY RECEIVED BY DATE RECEIVED CASH
� - ONLY
I A —, —