HomeMy WebLinkAboutMisc Letters i
' N
LITIESDEP---
2300 VIRGINA AVE M ST..LUCIE COUNTY UTILITIES-P.O.BOX 728,FT.PIERCE,FL 34982
FORT PIERCE,FL 34982 `
02J22J2011 15;04:01 NAME =1S0T\) P Cao pPDc��
DEBIT CARD X�( l /
DEBIT SALE ACCT.# �V v '7
r'
3
Card# )D00(XXXXXXXX6818 EP SERVICE ADDRESS J 1 1 r— �Ld �(�•'", '
Network; VISA E
Chip Card; US DEBIT
AID; A0000000980840 -EE
ATC; QOBS SUBDIVISION L-1E�1' LOT BLOCK.
TC. C9482BD10F6F5083 ?EE
1 CALL. BILLINGADDRESS (] BCIe �' G
SEQ#; 21
Bath#:
INVOICE 21 ,
E Approval Code; 484666 _L�
? L> MOV
PHONE# E IN/CLOSING DATE
Entry Method; Chip Read
T Mode; Issuer-,PIN Bypassed This application hereby request and authorises the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
SALE AMOUNT $521,25 riles 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.
U' CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/ `L C9
CUSTOMER COPY FED ID �I " J
SPOUSE SOCIAL SEC.
OFFICE USE ONLY . .
DATE RECEIVED 4.
CASH C-14"- / S 7" RECEIVED BY
r. •i;;e ;A," 6f ,i '1 •:rp,: s., t ,e .