HomeMy WebLinkAboutCOUNTY UTILITYC�77K
_ WATER COMM
J- SEWER RES
METER SZ. M/F
IRR
$; SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL. •
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
11 LATERAL
§ r D U TOTAL
ST. LUCIE COUNTY UTIL '
NAME 1l�
ACCT. # J
SERVICE ADDRESS J/
SUBDIVISION
_(!A,eRh(
BILLING ADDRESS
41�
'_BLOCK
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 i SOCIAL SEC/
SIGNATURE FED ID
NAME OF SPOUSE SPOUSE SOCIAL SEC.
pp F E USE ONLY
DATE RECEIVED e ( I CASH---ICHK # RECEIVED
RECEIVED
MAY 0 8 7111A
Permitting Deparcnit
St. Lucie C'r-