HomeMy WebLinkAboutProject Information A ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE FL 34982
NAME 1..=—i 1 � �� `_. 1l✓ �J
St. Lucie County - PCIS I � G, 14
04-12-2018 02:13:09 ACCT.# 1
17643/4215 ;P SERVICE ADDRESS G L
DAVIS, GLEN
112 EASY ST
FORT PIERCE --E 1
FL 34982 SUBDIVISION " I � LOT � BLOCK
3E
Amount Tendered: 519.00 kLL BILLING ADDRESS
Amount Paid: 519.00 qo `l _ 3
PHONE# MOVE IN/CLOSING DATE
Change Due: 0.00
Thank You 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,
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.
User ID: RODRIGUEZM CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/
Z'I e2�z_ FED ID '7
SPOUSE SOCIAL SEC. /
OFFICE USE ONLY '�
DATE RECEIVED L I L / CASH CHK# RECEIVED B `/-
RECEIVED
APR 12 2018
ST. Lucie County, Permittln