HomeMy WebLinkAboutST LUCIE UTILITIESSCANNED,
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ST. LUCIE COUNTY UTILITIES - P.O. BOX 728 FT. PIERCE FL 34982
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SERVICE ADDRESS 5LID aU k`' d- WKC,
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SECURITY DEP
SERVICE FEE
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SAME DAY FEE
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OVERTIME FEE
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BLOCK
BILLING ADDRESS 14-�0 - � rz�, AlLin 8/4
METER INSTALL.
CFC/WATER
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PHONE # -MOVE IN/CLOSING DATE
FPUA CFC
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CFC/SEWER
This hereby
GUAR. REV.
application request and authorises the'Utility to render water and/or sewage disposal
LATERAL
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
TOTAL
the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS
DEPOSITS ARE NONNEGOTIABLE OR TRANSFERABLE.
CUSTOM
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SOCIAL
�1 �-E" �l�U�.. FED ID SEC/
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NAME OF SPODUSE
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SPOUSE SOCIAL SEC.
rt7 q OFFICE USE ONLY �%
DATE RECEIVED !' l ' "CASH CHK #JOT 60 RECEIVED BY_`