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"ST.LUCIE COUNTY.UTIL/ITIES. .P:O.BOX728 fFT.PIERCE FI:34982
t. Lucie County - PCIS
3-2 - 2:21 :2614
IX USSELL ip SERVICE ADDRESS
)RT IERCE DR
I /
fount Tendered: 519.00 E SUBDIVISION• / LOT ' BLOCK
_ -
EE -CP -
ount Paid: 519.00
anse Due: 0.00I,L
`-
ank You
j PHONE# 7 � 3y 3Sv MOVE.IN/CLOSING DATE )
er ID: MURRAYA
This app hcahon'hereby request and authorizes the Utilityto render water and/or sewage disposal
services,ao the premises,descnbed above m accordance:with the.Utilities present;or future,tates
LATERAL rules and regulations,which by reference are made a part of this contract:Applicant agrees to pay
--- the Utility rom`tl forsuch seivices in'accordance with the estabhshed.;rules and_ regulations:
P P Y
$ TOTAL CUSTOMERS DEPOSITS ARE;NON NEGOTIABLE-0 ; TRANSFERABLE
CUSTOMER
SIGNATURE"
7: !
NAME OF
SPOUSE
SPOUSE.SOCIAL�SECJ� � .
� OFFICE S
E ONLY
DATE,-RECEIVED—3'C7tJ 17 CASH CHIC. RECEIVED BY
RECEI`:rD PSA z 0 U17