HomeMy WebLinkAboutMis Letter WATER COMM ST.LUCEE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE FL 34982
SEWER RES
NAME
METER SZ. M/F � L[��C)
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IRR ACCT.#
$ SECURITY DEP SERVI E' DRESS
SERVICE FEE
SAME DAY FEE ��J /'
SUBDIVISION �i�iL_,"J LOT O BLOCK
OVERTIME FEE
METER INSTALL. BILLINGADDRESS I/ 5 S�ij �,. A �,� ��.�p �
CFC/WATER Po r Lt I c�'Q r l=L. 3 4 4 8
FPUA CFC PHONE#__k:5,-[
CFC/SEWER 2 MOVE IN/CLOSING DATE
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
the Utility promptly for such services in accordance with the established rules and regulations.
'— TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
!USTOMER SOCIAL SEC/
IGNATURE FED ID
AME OF SPOUSE SPOUSE SOCIAL SEC.
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OFFICE USE ONLY / �/� �Q
DATE RECEIVED*.
CASH CHK# RECEIVED BY ��C�:1�( [/v
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RESTRICTIONS , ...
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C�pSS•E An...... OR°�f veMle wMh a GV WR fesslhan 28 001 bs or any R� .
18 DAYS CF ADDI�ESSOr}HA�CN��'E' -
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