HomeMy WebLinkAboutNew Customer Application FeesWATER
SEWER
g METER SZ.
�1►,LPL -� ST LUCIE COUNTY WATER-& SEWER -DISTRICT (SLCU)
NEW CUSTOMER APPLICATION
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COMM
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M/F
IRR
$ OD Did SECURITY DEP
SERVICE FEE
SAME DAY FEE
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OVERTIME FEE
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'7''30, 06 METER INSTAL
73_ i%0 CFC/WATER
FPUA CFC
3 .aQ, CFC/SEWER
0� GUAR. REV.
LATERAL
$ J� TOTAL
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5313 V
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FL
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SUBDIVISION � . LOT l < c;2 BLOCK"3
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BILLING ADDRESS 60 &A &,ee , +9jQWU 64#� re2e F% 3Qf 03
EMAILADDRESS:
PHONE #_ MOVE IN/CLOSING DATE
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 iITT%il'Y SERVICE
APPLIED FOR ON THE DA'Y THE WATER METER OR OTHER trMnY SERVICE CONNECTION IS INSTALLED AT
1..�.rJ APPLICANT'S PROPERTY, REGARDLESS OF WREN APPLICANT STARTS UTEUMING THE METER AND/OR SERVICE.
ER SIGNATURE SOCIAL SEWED ID
NAME OF SPOUSE %- �SPOUSE SOCIAL
OFFICE USE ONLY
DATE RECEIVED U lD �t CASH CHECK# o� ?(A�3 RECEIVED BY
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