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St. Lucie County -PCIS
IS
06-01-2020 WAM COMM S"i:LUCIR COUNTY UTILITIES-ip O.BOX 72&�PIERCI>,FL.34982
19667/5220 SEWER RES. NAMES
CLINE, DOYLE JAMES 115MEMP,Sz. laltF
6103 SPRUCE DR tRit ACCT# �� �J -
FORT PIERCE ouCQ
FL 34982 h�i�'�/ SECURI'T'Y DSP SIMUCE ADDRESS �C) � �
Amount tendered: 519.00 f
SERVICE FEE
SAMS DAY FEE SUBDIVISION LOT - -- .BLOCK
Amount Paid: 519.OQ
OVERTIMEFEE
0.00 � � „C�� METERINSTAMT ' BILLINGADDtRESS `
Change Due. "�� N -p t C a C�
CFt",lPFATER � �
Thank You
FPUA CFC PHONE# __1 t)}1 C*Z 2_ `7 113ci 9emow IN/CLOSING DATE q
CFC/SEWER
User ID: RODRIGUEZM GUAR.REV. This appiication hereby r%ucst 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,
LATERAL rules and regulations,which by reference are made apart of this contract.Applicaut agrees to pay
the ijtility promptly for sucb services in accardatrce with the established rules and regulations.
YbMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERAME,
. . . aMER -.. SOCIAL SE `-t ?S Ic-
5IG FED Ill
E CA
NAME OF sPOUS SPOUSE SOCIAL SEC. X54-12"" ��
OFFICE USE ONLY
t
RECEIVED
DATE RBCEMED CASH CHK# BY
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