HomeMy WebLinkAboutProject Information ST.LUCIE COUNTY UTILITIES-P.O.BOX 728,FT.PIERCE,FL 34982
ST LUCIE 0itl I in u P
2300 VIRGINA AVE NAME
FORT PIERCE,FL 34982 99
57
04-20u 14 :09:56 ACCT.#201 cie 04/20j2018 _
CREDIT CARD SERVICE ADDRESS \51? 0 p r o C e
15599 VISA SALE 'P
MARTINEZ, Card XX)0000000lXX7162
5705 SPRU SEQ#: 15
FORT PIER Batch#: 873 E SUBDIVISION LOT BLOCK
982
INVOICE 17 E
Approval Code: 031003 iLL BILLING ADDRESS [� So Y) Se
Amount Te Entry Wed, Swiped
Amount Pa ": Onliv
Tax Amotnt;
X0,00 PHONE# MOVE IN/CLOSING DATE
Change Du n
SALEAMOUNT $521,24 This application hereby request and authorizes the Utility to render water and/or sewage disposal
Thank You 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: CUSTOMER COPY CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/
FED ID G 3 ( D(E)
SPOUSE SOCIAL SEC.
� OFFICE USE ONLY
DATE RECEIVED CASH CHK# RECEIVED B