HomeMy WebLinkAboutWater bill receipt +` WATER I COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT:PIERCE FL 34982
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SEWER x
NAME
METER SZ. M/F `
ACC
IACCT.#!
SECURITY DEP SERVICE ADDRESS
SERVICE FEE
SAME DAY FEE
SUBDIVISION LOT BLOCK i
OVERTIME FEE
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7+ �� METERINSTALL.' f
CFC/WATER
- Al FPUA CFC f f
PHONE# MOVE�I�}N`�I OSING DATE
CFC/SEWER �Se. r i n one- ""gym°l- �eY c
. Cann ortS - axz � 0+.1 Proper--f-� R�'�\1E.
N. 070 '00 GUAR,REV, this application hereby request and an orczes the Utility to render water and/or sewage disposal
�a services to the premises described above in accordance with the Utilities present or future rates,
Jf Z_ ' LATERAL rules and regulations,which by reference are made a part of this contract.Applicant agrees to pay
n to T 6r- hale_ —t— the Utility promptly for such services in accordance with the established rules and regulations.
� o TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE ORTRANSFERABLE.
CUSTOMER
r' f SOCIAL SEC! /
SIGNATURE G= _Z �'/` "..0 / FED ID �~-`�%'J
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NAME OF SPOUSE J 1 1 SPOUSE SOCIAL SEC. i t (J
OFFICE USE ONLY �(�'
DATE RECEIVED y� �0 CASH CHK# ( E[VED BY__ ,
IL WATER COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE FL 34982
f SEWER RES NAME Ill%Qon 4
u METER SZ. MIF ACCT.# 1 e�._6-- /73 6
SLCURITY DEP SERVICE ADDRESS ! �v✓ ��7 - k.
SERVICE t
.SAME DAY PER
SUBDIVISION LOT BLOCK
OVERTIME FEE
METER INSTALL. 'BILLINGADDRBSS= fl,�i�
CFClWATER
Af k FPUA CFC � I�PHONE# 0_n f� "`I� OL( MOVE IN/CLOSING_,�ATE��,
40 Af CFC/SEWER �JUSe` -451 t dw1cE /L�{e�t-o� rc +�- �
Cor�►�QrtQ arer =a �^ t
1Db GUAR.REV. This application hereby request and authorizes the Utility to render water and/ r sewage disposal
DO 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
nn 8t1r o R44 the Utility promptly for such services in accordance with the established rules and regulations.
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
3USTOMER - f 1 SOCIAL SEC/
UGNATUI'E �= _~- f-� FED ID 4n
4AME OF SPOUSES0�1 Zl� .' 1 �'� SPOUSE SOCIAL.SEC.
I.
OFFICE USE ONLY, 1l
DATE RECEIVED 172-0 CASH-- .S ..rvivpn RV 1 1i