HomeMy WebLinkAboutSLC Utilities receipt f
WATER �r J d� �
y a COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE FL 34982
A�SEWER RES NAME
METER SZ. _ 3
M/F ✓� ) n
ACCT:# �I
IRR
S { SECURITY DEP SERVICE ADDRESS ) rl
SERVICE FEE � ' G�T7
`
SAME DAY FEE 1 ����
SUBDIVISION`S a\"tl] �' LOT BLOCK
OVERTIDM FEE
METERINSTALL.' BILLIN DRESS'::;
CFC/WATER,
FPUA CFC
PHONE#' z.1.l�J.` �� 1 MOVE IN/CLOSING DATE
CFC/SEWER
GUAR REV This'application tiereliy request and aathor ies the Utility to render water and/or sewage disposal
services•to'the prei ii§e§'described above in accordance with the Utilities present or'.future rates,
LATERAL rules and regulations;which by reference are made a part of this contract.Applicant agrees to pay
$ `f V TOTAL the Utility promptly for such services in accordance with the established rules and''regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER gun SOCIALSEC/
S1 FED ID_ y
NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY. RECEIVED BY
DATE RECEIVED 'Cb CASH CHK#D( (� ` 1
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