HomeMy WebLinkAboutUtility Receipt WATER COMM ST.LUCIE COUNTY UTILITIES.P O BOX 72&FT PIERCE,FL 34982
SEWER RES NAME
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SECURITYDEP SERVICE ADDRESS Z g f`)
SERVICE FEE
SAME DAY FEE //
SUBDIVISION_ VeeG (fo 44 LOT BLOCK
OVERTIME FEE
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MOVE IMCLOSING DATE
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GUAR:REV. This application hereby request and authorizes the Utility to readerwater 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 a part of this contract_Applicant agrees to pay
$_ �l�l�� t t�y the Utility promptly for such services in accordance with the established rates and regulations.
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SOCIAL SEC/ `
SIGNATURE 4 FED ID
NAME OF SPOUSE—U— �j neC+l � SPOUSE SOCIAL SEC314 6'
OFFICE USE ONLY,J
DATE RECEIVED CASH CHK# Y V'4r RECEIVED BY
St. Lucie County - PCIS
04-08-2020 11 :01 :20
19488/7158
COX, TAMMIE r
123 QUEEN FEDERIKA
FORT PIERCE
FL 34949
Amount Tendered: 3,509.25
Amount Paid: 3,509.25
Change Due: '0.00
Thank You
User IQ: RODRIGUEZM