HomeMy WebLinkAboutST LUCIE COUNTY UTILITIESI
WA ER COMM
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66 SECURITY DEP
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SAME DAY FEE
OVERTIME FEE
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NAME OF
DATE RECEIVED I
NAME
ACCT. #
SERVICE ADDRESS
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BILLING ADDRESS SCANNED
BY
9t. Lucia 'MW
PHONE # MOVE IN/CLOSING DATE
This application hereby request and authorizes 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 apart 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 ID
SPOUSE SOCIAL SEC.
OFFICE USE ONLY -� -
CASH CI33��#'""° t L RECEIVED BY i' `d b' p