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Note:
rt Pierce Utilities Authorfty
►mmitted To Quality"
Wastewater Engineering 90ANNED
BY
16th Street , �����g WO
FL 34950
NO: SORD00003532636
NID: 10007618
3: 486.0 WATERSONG WAY JENSEN BEACH FL USA 34(,
JAL INFO:
1M CHG WATER CAPITAL,IMPROVE CHARGE
FEE NEW WATER CONNECT FEE NEW CUST
IT INVOICE DEPOSIT FOR INVOICE NEW CUST
Phone (772) 466-1600
Fax (772) 461-1938
4D DESIGN ti 4
t
NLI� NO�EWER� �`
PREPARED BY: SIZEMORE
xGOST H GES
�-U
mm-
$350.00 $350.00
$0:01 $1,288,70.
$0,01 $40:00
$0.01 $60.00
I
,rs will be assessed wastewater ch'arges`;the;day they'cormect'to the:w8steWater system or within 365 days from date wastewater
on Charge is paid whichever Is first Ttrecost of.the service Brie from: the point of delivery at the property line to the
Iilding is the responsibility of the customer and% Is 7hdte included In ttiisinvoice. State laws require that a permit from the Health
ent must be abfained prior to>initiatin a septic fatrlEabandonr,dent.'.0 n acttoi Health Department at (772) 873-4931.
;tion cost estimates are based on current labor, equipment and material prices. Actual costs of construction will be determined at
►letion of the project. Should unforeseen circumstances be encountered during construction, including but not limited to adverse
conditions and construction conflicts, the customer will be responsible for increased costs. Additional costs incurred by the
7,s0gRl not exceetl:fifeen (1'5) percent of the total estimated construction costs shown above. Estimated costs paid by the
that excee'd'the actual cost of construction will be refunded by Fort Pierce Utilities Authority.All fees are due prior to any
.1--
submitaccepted Customer
Cust mer Signature:
Print d Name:
PAGE t OF 1
A bill will be provided following acceptance of the Customer Invoice once signed and dated. Please
to Customer Service at 206 South 6th Street, Ft. Pierce, FL 34950 or call (772) 466-1600 to setup an
Date: .
PRINTED ON. 07/16/2018 AT 03:31 PM