HomeMy WebLinkAboutProject Information ST LU �TIES DEP ST.LUCIE COUNTY UTILITIES-P.O.BOX 728,FT.PIERCE FL 34982
2300 VIRGINA AVE
FORT PIERCE,FL 34982 NAME
03/01/2018
CREDIT CARD 15:10;29 (� /
ACCT.#
MC SALE l
Card# PDRESS
XXXXXXXXXXXX9910 -
S R A
ChQ Card: F
MasterCard
AID, A0000000041010E
ATC:
TC: 0023 SUBDIVISION , LOT BLOCK
DE384629E28450C4 PE
SEQ#; BILLINGADDRESS
latch#; 17 ILL.
'VVOICE 837
�xOval Code; 17 �-
ltrY Method; 001010 PHONE # I I 1
Lj
ode: Chip Read MOVE IN/CLOSING DATE
Issuer This application hereby request and authorizes the Utility to render water and/or sewage disposal
LEAMOUNT services to the premises described above in accordance with the Utilities present or future rates,
��I�� 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.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER COPY SOCIAL SEC/
FED ID
SPOUSE SOCIAL SEC.
uWF1tCE USE ONLY
DATE RECEIVED CASHAd
CHK# RECEIVED BY I& f
MAR 01 '2918
ST. Lucie County, Permitting