HomeMy WebLinkAboutST LUCIE UTILITIESr WATER :. COMM ,ST LUCIE COUNTYUTILxT1[ES - P.O BOX 728, FT. PIERCE, FL 34982
SEWER RES NAME •
'- METERSZ. M/F
IRR • ACCT. #
. t k SECURITYDEP-SERVICE.ADpRESS
SERVICE FEE
SAME DAY FEE .1 �' .
,.... SUBDIVISION. i " i P LOT 13LOCK
. OVERTIME FEE
i METERINSTALL.' BIi,L1NGADDRESS
�- CFC/WATER
FPUA CFC PHONE # i t'-' MOVE IN/CLOSING DATE
CFC/SEWER
GUAR. REV. This application hereby request and authorizes the Utility to render water and/or sewage dispo
services to the premises described above in accordance with the. Utilities present or future gate
i LATERAL rules and regulations, which by -reference are made apart of this contract. Applicant agrees to p,
the Utility promptly for such services in accordance with the established rules and regulation'
TOTAL- CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE'.
''CUSTOMER SOCIAL SEC/
r 1f €� _._ FED 1D
- . SIGNATURE ..�� ,i.(�t !.� tLf -- .. , .
NAME OF SPOUSE SPOUSE SOCIAL SEC.
1 � * OFFICE ICE USE ONLY
DATE RECEIVED , ' r, CASH CHK #' RECEIVED BY
_ RECEIVED
AUG '0 8 2018
ST. Lucie County. p.rMittin