HomeMy WebLinkAboutMisc Letters - -WATER COMM ST LUCIE.COUNTY UTILITIES-P.O.BOX 728,Ft.PIERCE,FL 34982
SEWER _RES NAME
METER SZ. M/F
IRR ACCT.#
$ SECURITY DEP SERVICE ADDRESS
SERVICE FEE " Lo�
SAME DAY FEE SUBDIVISION LOT BLOCK
OVERTMIE FEE / �
METER INSTALL.' BILLING ADDRESS ✓ �/ — / 1
CFC/WATER
FPUA CFCPHONE# �d� /Oy 7/
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,
' V 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.
CUSTOMER SOCIAL SEC/
SIGNATURE ----------=-- �_._..FED ID
NAME OF SPOUSE V .1� S, ` (,(.p�.S SPOUSE SOCIAL SEC.
�� / fJi,trOFF CE USE ONLY �� N v / �
DATE RECEIVED` 1" . li!l: CASH?1'1 7 CHK# RF.rZ,