HomeMy WebLinkAboutFort Pierce Utilities, payment slip URTHOUSE BOX ANNEXATION AGREEMENT
Fort Pierce Ut i 1 i t i es INDIVIDUAL
206 S 6th Street
Fort Pierce, FL 34950 PETER MASE,ASINGLE MAN
Telephone No. (772) 466-1600 1209 AUSTRALIAN AVE j
06/17/19 3:39PM FT.PIERCE FLORIDA 34982 I
liumber(s):
Receipt #: 006190617000013
Customer #: 257622
Location #: 10007907 1209 AUSTRALIAN AVE, PIERCE,FLORIDA 34982
For: PETERR MASE Location Address
Payment Received: 2,690.00
Amount Tendered Credit Card: 2,690.00
Authorization Number 093915 Mailing Address(if different from location address)'
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Payment Will be posted: 06-17-2019
Register: CASHIER6 le Utilities Authority for water service and/or sewer service outside the City limits of
,cribed property which I own,to wit:
Thank you - Have a nice day.. . . HE TROPICS",according to the Plat thereof,recorded in !1
Records for St. Lucie County, Florida. II
NEW HOURS M-F 9AM - 5PM
DRIVE THRU 8AM - 5PM
WWW.FPUA.COm est for water service and/or sewer service to my property, that if my property either
of Fort Pierce, Florida, as such term is defined in the Laws of Florida, is subject to a
bnt where contiguity has been waived by the County, or may otherwise be lawfully
* Budget B i 11 i ng Now Available 'as an application for the annexation of my above-described property into Ithe City of
4,cbyontiguous to the above described property owned by the undersigned,at the time
CUSTOMER COPY for myself, my heirs, successors and assigns approve the annexation of my
onsent thereto in the event that it,or any area including it, is proposed for annexation .
;tions to annexation of the property and agree that this Agreement shall be construed
to satisfy any requirements of law for consent to,or approval of,such annexation now or hereafter required.
I further confirm that this Agreement shall be binding upon my heirs,successors or assigns and that this document may be,recorded in
the Public Records of St. Lucie County, Florida for the purpose of serving as notice to all persons or entities.
In Witness Whereof, I hereunto set my hand and seal this�ay of I Tu� ,2019.
SIGNED,SEALED AND DELIVERED IN OUR PRESENCE AS WITNESSES:
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Witne s i ature Signatuter Mase, a single man
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A W4 MEV U
Printed Witne s Signature Printed Signature
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1209 Australian Ave, Pierce, Florida 34982
Address
lMtne ign u e
,q/yk ,,/ 6 /,c for
Printed Witness ignatum-
STATE OF W `"
COUNTY O5
I hereby certify that on this day before me, an officer duly authorized to administer oaths and take acknowledgments,
personally appeared Peter Mase, in whose name the foregoing instrument was executed, and that he severally acknowledged
executing the same freely and voluntarily, and that I relied upon the following form of identification of the above-named person:
Driver's Licenses,and that an oath was not taken.
RUBBER STAMP NOTARY SEAL Witness my han O pfficial Seal i e Co t and State last
aforesaid this '`day of /�= A.D.2019..
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��►Y Notary Public State of Florida
Tanya.Rios 4
y- My Commission GG 158853