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M ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE FL 34982
NAME
St. Lucie County - PCIS t j�
05-01-2018 10:31 :38 ACCT.# t l V�
17666/4220 =,P SERVICE ADDRESS i�0CQA�'I
KEEGAN, MARY J.
120 EASY ST
FORT PIERCE E
FL 34982 SUBDIVISION � � LOT BLOCK
EE
ro e
Amount Tendered: 520.00 %LL BILLING ADDRESS
Amount Paid: 519.00 Q n
Change Due: 1 .00 PHONE# MOVE IN/CLOSING DATE
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/
FED ID ��
SPOUSE SOCIAL SEC.
O FICE USE ONLY
DATE RECEIVEDCASH CHK# RECEIVED BY