HomeMy WebLinkAboutUtility/Copy of Paid Bill •
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}T COMM ST LUCIE' OUNT`Y UTILITIES O BOX'728,FT PIERCE,FL"34982 C4 0 O
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• SEWER RES �] I q d
( NAMEe h Q )v j �7�. Z �� �- ,-, ?�
> METER SZ M/F= :-, *. ���
ACCT# • .
$'. S,t O SECURITY DEP SERVICE ADDRESS /�7 / //, 1 — fi ra�l ^� . :" • ,!
SERVICE FEE
SAME DAY FEE •
SUBDIVISION LOT BLOCK ".. .
OVERTIME FEE
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��b BILLINGADDRESS / '-(
.` `/;�,� � ,JMETER INS'T'ALL '. r.,-:::,-{.--./
73j, • s•CFC/WATER ' 7 ;V%" •
FPUA CFC ' • gf
PHONE# �,, �,7 �. ��, MOVE IN/CLOSING DATE
CFC/SEWER. •
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happlication hereby request'and authorizes the Utility- .;,.,:,,4-.:,.,#nder water and/or sewage disposal•
X - services fo thekpremises•described above in accordance with the Utilities piesent:or future rates,
' "LATERAL rules and regulations,which by reference are made a part of this contract i hcant agrees to pay,
(� [ the Utility prom tly,for such servicesr•in accordance with the established rules and regulations.
4 �. CUSTOMERS DEPOSITS ARE NONVEGOTIA'$LE OR TRANSFERABLE .., i
___-- CUSTOMER .,4z, ', , r, /1. (� 9 rI 1�`—� r SOCIAL SEC/
SIGNATURE A �" 14. I.G = FED ID t- G / V
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