HomeMy WebLinkAboutMisc Letters WATER COMM ST.LUCIE COUNTY UTILITIES,-P.O.BOX 728 FT.PIERCE FL 34982 _
SEWER _RES NAME 0/0-D M t. (n.
METER S2. M/F yf�
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_ ACCT.# l `�
lJVIIJ11ASECURITY DEP SERVICEADDRESS
SERVICE FEE. PA aC"
SAME DAY FEE
SUBDIVISION �, LOT —BLOCK_tU�
�} OVERTIME FEE
---- 'V METER INSTALL. BILLINGADDRESS_ 5 ,00
CFC/WATER �,• "I t�P`{"C�.—� 1, S Y� � F�
FPUA CFC PHONE#- 71,9 qb S-_3/22Q MOVE IN/CLOSING DATE
CFC/SEWER
GUAR.REV. 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,
LATERAL rules and regulations,which by reference are made a part of this contract.Applicant agrees to pay .
�✓ � C TOTAL the Utility promptly for such services in accordance with the established rules and regulations.
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CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMERSOCIAL SEC/
SIGNATURE ' lamz Q, FED ID t4 a
NAME OF SPOUSE SPOUSE SOCIAL SEC.
1
'CSE ONLY
H CHK# RECEIVED BY hbAl
DATE RECEIVED_4 CAS