HomeMy WebLinkAboutSLC Utilities ReceiptX WATER COMM
SEWER RES
METER SZ. M/F
IRR
$ $85.00 SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
$434.00 METER INSTAL
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ $519.00 TOTAL
ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL 34982
NAME Deb Lundgren
ACCT.
SERVICE ADDRESS 4710 E. Midwav Rd.
SUBDIVISION Indian River Estates LOT
BILLING ADDRESS 4611 S University Dr #464, Davie Florida 33328
EMAIL ADDRESS: muscles1122@gmall.Com
PHONE # 954-647-8768
MOVE IN/CLOSING DATE TBD
BLOCK 34
This application hereby request 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,
rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay
Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER Z�)¢6 ��
SIGNATURE SOCIAL SEC/FED ID�
NAME OF SPOUSE YUSuf Abdur-Rahman SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED CASH CHK# RECEIVED BY