HomeMy WebLinkAboutMisc Letters WATER COMM ST.LUCIE COUNTY UT TIES-P.O.BOX 728 FT.PIERCE FL 34982
SEWER RES
NAME
METER SZ. M/F
/1 IRR ACCT.# (� %
$ cJ . lJ Q SECURITY DEP SERVICE ADDRESS Zi/, `
Ii ® U SERVICE FEE
SAME DAY FEE �f
SUBDIVISION LOT _BLOCK
OVERTIME FEE /�, f � , o
METER INSTALL.
BILLING ADDRESS �• /-�' ( 4bd AK-f
-01146 d O Q4 CFC/WATER
FPUA CFC
PHONE — /LP 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
�y �l the Utility promptly for such services in accordance with the established rules and regulations.
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER ti SOCIAL SEC/
SIGNATURE FED ID 4, -
NAME OF SPOUSE SPOUSE SOCIAL SEC.
ONLY
DATE RECEIVED
44& CASH OFFICE USECHK#:30796 U RECEIVED BY 1d_