HomeMy WebLinkAboutProject Information `ST.T;UGIE>CpTY'UTII,ITIES -P,O.BOX 728.FT PIERCE,PL34982.
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-NAME ! s
St. Lucie Count -
03-21-2019 63:2 IS
A �
CCT.' .
18575/4333 ` . �;� •. ", �
DOTY, ADAM SERVICE ADDRESS _
5504 HICKORY DR xi $
FORT PIERCE
i FL 34982
Amount Tendered: 600,00 "SUBDIVISION., ` "LOT 1;� BI OCK `
fes. p a. . .• - • fia...:
Amount Paid: 4
519.00 ,BILLING.ADDTtESS rt=
Change Due: 81.00 ;
Thank You
'PHONE MOVE IN/CL'OSING DATE
User ID: MURRAYA r'
This application hereby request and authorizes the Utility:to render water and/or sewage disposal
'""^`"''''-` ^%•^•��--Jnr .•�r=eo.s�.�„n„r,..,m„t.,.,,,,-,A,.n,u�*,»� 4Wµ M :service'sto lie�piemises descnbed.above in acaoidance with the:Uttlrties_:present:or future'rates, ,
LATERAL : rules-arid regulations,which by reference are made a part of flus contract:Applicant agreesto
the Utility grorngtly for such services ui accordance with the established'niies and reguIahons
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE
CUSTOMER "�^ SOCIAI,SEC/
-SIGNATURE k ID } �i� �/J� t A to q
NAME OF SPOUSE SPOUSE St)CIAL SEC. ..
OF E 1USEIDNLY
DATE RECEIVE CASH CHK# RECEIVED BYiL
�NUs
7MM � A GU i
ST.Lucie County,Permitting