DANIA BEACH WATER UTILITIES DEPARTMENT

DANIA BEACH
APPLICATION FOR UTILITY SERVICE

ALL UTILITY ACCOUNT APPLICATIONS ARE SUBJECT TO A UTILITY DEPOSIT AND THE FOLLOWING APPLICATION FEE:
RESIDENTIAL $3.50 PER APPLICANT NAME, CANADIAN RESIDENTIAL $15.00 PER APPLICANT NAME, COMMERCIAL
$20.00 PER APPLICANT NAME. ALL APPLICANTS MUST PROVIDE A SOCIAL SECURITY NUMBER OR FEDERAL ID
NUM BER TO RUN UTILITY CREDIT CHECK.

NAME: Hugo Cárdenas

PROPERTY ADDRESS: 741 Sterling Road, Dania Beach FL 33004

MAILING ADDRESS: renaebnb1@gmail.com

TELEPHONE NUMBER (s): Home (761) 416-6302 Work Cell (305) 304-8354
(Phone numbers will only be used in case of an emergency)

OWNER (PROOF OF OWNERSHIP REQUIRED)

I understand and agree that as a condition of receiving utility services, I will be subject to the provisions of
Chapter 27 of the City’s Code of Ordinances, as amended from time to time by the City. I further understand
that unpaid utility account balances of former owners constitute a lien on the real property, and any previous
unpaid balances become my responsibility as the owner.

HC

x RENT (NOTARIZED LEASE REQUIRED)

NAME OF OWNER: Global Re LLC

APPLICANT SIGNATURE: Hugo Cárdenas DATE: 06/15/2023

FOR OFFICAL USE ONLY

CUSTOMER ID# DATE PROCESSED

DEPOSIT AMOUNT ENTERED BY

RESIDENTIAL CANADIAN RESIDENTIAL COMMERCIAL