HomeMy WebLinkAboutMisc Letters ST.LUCIE'.COUNTY UTILITIES-P O BOX 728,FT PIERCE,FL 34982
NAME C .,L - �1
METER SZ MIF
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1 -' T SERVICE.ADDRESS "f U`C-�,.
SECURITY DEP �!`
SERVICE PEE
' SAME DAY FEE ` `~�
SUBDIVISION ! . LOT:.tD`-� BLOCK" L
(� OVERTIME FEES
`-} iJ "` METERINSTALI'1: .BILLING ADDRESS ' sc (S
CFC/WATER !1 lv t�[ch -.
CFCC,
PHONE# ' 1 c (o 1 MOVE IN/CLOSING DATE
CFC/SEWER
GUAR RBV This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises described above m accordance with the Utilities present or future rates,
LATERAL rules:and regulations,,which by reference are made apart afth s contract Applicant agrees to pay
the Utility'promptlyLfor such;services in accardaFce with the established rules and regulations..
I TOTAL:
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.,
CUSTOMER SOCIAL SI ` !!p'
SIGNATUR `', FED m `f 0 'T f ;/" .
'
NAME.OF SPOUSE' SPOUSE SOCIAL SEC:
OFFICE USE oNI,YAPR
DATE"RECEIVED r;� t I .CASH CHK# � RECEIVED BY { 4''2Q1Q
�_ _��_ __ _._P8rmJtting Cepettment
r_ _ _�— St.Lucie County
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77 <,..,.... 1 ,.
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i elAY:k'' PIERCE,F
r-- BOX 728. c-
P.O.Bv
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L 34982
NAME
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ADDRESS ' ' ' - • ? BLOCK
1
peIS
cie reuntY11-:07:26
St. L122010
04-24 661/5170vEsT
17v pARK INVEST LEGACs'pp.liCE DR i RC
B
i 'LUNG • CX-c". ' ` .,,,„" /CLOSING,' disposal
p0RT r .., :
510.00 SUBDIVISION I - LOT
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: '' 44 ' ",' ,• 9 moyF, jewage-,, , 1 es
FL dff°
t or future
ed:
00
Amount Tend6r 519.
. ,, - tst, - ,:, , . • 'Utility to render Utilities Applicant gees
Paid:.
hories the
ce with the
to pay
the Utility
0.00
Amount
ication hereby
PHONE
tan a ••• ,uecorslall, f this.contract...,established,rule
:
eference are made a part
Change DUB
k You
1L 30
This thePre -which•bY •.services' 'in accordance•NEGOTIABLE
Than
vices to
Tr, ,AHRRAYA ! 'd fag!'• '1 ',for sa Nomtit -,, , - ,
:
DATE
rules
an
S DEPOSITS ARE
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CUSTOMER - --0SEbNL /Z7t1 ' ,
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DATE RECEIVEI)
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