HomeMy WebLinkAboutNew Customer ApplicationATER
Y:_' SEWER
METER SZ.
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.......... ES NAME R
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ACCT. #
ST LUCIE COUNTY WATER & SEWER DISTRICT (SLCU)
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NEW CUSTOMER APPLICATION
IRR
SECURITY DEP
—SERVICE ADDRESS
SERVICE FEE
Plat # 4
SUBDIVISION6eez -S� m LOT BLOCK
-SAME DAY FEE
OVERTIME FEE
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METER INSTAL
131WNGAODKESS.
CFCIWATER
EMAILADDRES*S:.
FPUA CFC
PHONE MOVE IN/CLOSING DATE
CFCJSEWER
This application hereby requests and autho:rizes the Utility to render water and/or sewage disposal
GUAR. REV.
LATERAL
services to the premises described above in accordance with the Utilities present or future rates, rules and
Utility
regulations, which by reference are made a part of this contract. Appi !cant agrees to pay promptlyfor
$ TOTAL
such -services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE ORTRANSFERABLE.
-APPLICANT AGREES THAT APPLICANT WILL ]BEGIN PAYING :BASE FACILITY CHARGES FOR THE UTnffY SFRNqCF,
APPLIED FOR ON THE DAY THE WATER METER OR OTHER UTUM SERVICE CONNECTION IS INSTALLED AT
P-1
APPLICANT'S PROPERTY.- REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METERANDIOR SERVICE.
'ED ID
CUSTOMER SIGNATURE: SOCIALSEQ/flE
NAME OF SPOUSE I SPOUSE SOCIAL -
OFFICE USE ONLY
DATE -RECEIVED �CU94**_ _k CASH RECEIVED BY