HomeMy WebLinkAboutSLC Utilities ReceiptVWATER COMM ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL 34982
SEWER RES
4 -NAM
METER SZ. M/F
ACCT. #
IRR
SECURITY DEP SS
SERVICE FEE
SAME DAY FEE
,-ST'
OVERTIME FEE
Z-7L/ 00 METER INSTALL
NAME OF SPOUSE
® r I- 19(t re- Z,
;LOT
7�
07-
CFC/WATER
FPUA CFCMOVE IN/CLOSING DATE
CFC/SEWER
GUAR. REV. This application hereby request and authorizes the Utility to render water and/or sewage
services to the premises described above in accordance with the Utilities present or futul
LATERAL rules and regulations, which by reference are made a part of this contract. Applicant agree
the Utility promptly for such services in accordance with the established rules and regi
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
I -
DATE RECEIVED
FED ID
SPOUSE SOCIAL SEC.
OFFICE USE ONLY.
CASH
RECEIVED BY