HomeMy WebLinkAboutST LUCIE COUNTY UTILITIESsF'
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.WATER
COMM
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METER
RES
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MJF
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SECURITY'DEP
SERVICE FEE
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SAME DAY FEE
OVERTIME. FEE
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METER INSTALL,
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ 2 V, TOTAL
CUSTOMER
SIGNATURE
NAME OF SPOUSE
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DATE RECEIVED C) 1
ST. LICIE Co!IY Ty UTILITIES
IES _Y.O. BOX 728 19 T. PIERCE FL 34982
NAME
ACCT
SERVICEADDRESS1 ✓C� -
BILLINGADDRESS
vt
PHONE #
MOVE 1N/CLOSING DATE'.
This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises described above yin 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
SOCIAL SEC/
FED 1•D
SPOUSE SOCIAL°SEC.
USE ONLY
C � ` RECEIVED BY�-1 ,
AUG 0 1 20'S
ST. Lucie County, Permitting