HomeMy WebLinkAboutST LUCIE COUNTY UTILITIES!� WATER
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BILLING ADDRESS
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34, R 57
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PHONE # J% '� �U "�? / MOVE IN/CLOSING DATE
This application hereby request and authorises 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
SIGNATURE i� �--� 1� Acl �[ �1 0FED ID SECT`
NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVEDCASH I Gi ,
' �. �. CHK #� YJ RECEIVED BY