HomeMy WebLinkAboutWater bill receipt WATER �j COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE- FL 3498Z
SEWER RES
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S METER SZ. MI NAME `
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ACCT.#__ SJJ /,
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r1� •u SECURITY DEP SERVICE ADDRESS
Sf ' 00. SERVICE PER
SAME DAY FEE
OVERTIME FEE
SUBDIVISION LOT BLOCK
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�'7'"ff+ 0a METERINSTALL.• BILLING ADDRESS
73 CFC/WATER a
FPUA CFC f
PHONE --t- �-b MOVE TN/MOSING DATE
h CFC/SEWER S2. i r1 roue. Ae-_ z_or- aft w c
n ortS axat_ � a ,I P�operf� �H',t�vE.
A �� ff GUAR,REV. This application hereby request and-au orizes the Utility to render water and/or sewage disposal
5 Q p services to the premises described above in accordance with the Utilities present or future rates,
U LATERAL rules,and regulations,which by reference are made a part of this contract.Applicant agrees to pay
the and
promptly for such services in accordance ivith the established rules and regulations.
' n TOTAL CUSTOMERS DEPOSITS AR13 NON NEGOTIABLE ORTRANSFERABLE.
CUSTOMER / SOCIAL SEC/ /
SIGNATURE FED 2D C_
NAME OF SPOUSE L 1 1 SPOUSE SOCIAL SEC. f� 6 '>3 0
OFFICE USE ONLY t�/�' �
DATE RECEIVED fl CASH CHK# 1JItE'I;EIVED BY_ .( '/I •
JL WATER COMM ST.LUCIE COUNTY UTILITIES P.O.BOX 728 FT.PIERCES FL 34982
SEWER NAME _ II�� 4 ! ✓ /I �f/-�
METER SZ, M/F
IRR ACCT.#
SECURITY DEP SERVICE ADDRBSS log.
v k L.
3i ` 00. SERVICE FEE t' CfL
SAME DAY FEE
OVERTIME FEE
SUBDIVISION LOT BLOCK
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`'1> + Cam_____METER INSTALL.' BILLINGADDRESS f�iLg
73.�� CFC/WATER
FPUA CFC PHONE# "1 ! `"`I r l MOVE IN/CLOSING_DATE
CFC/SEWER JaSe bnK+E �1t o4 a�+fcsi` -r
b b D GUAR,REV. This application hereby request and authorizes the Utility to render water and/ r sewage disposal
DO
JI 25 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
�/� 6ur0o'� the Utility promptly for such services in accordance with the established rules and regulations.
y TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTL4BLE OR TRANSFERABLE.
CUSTOMER ! SOCIAL SEC/
SGNATURE FED ID 1, '
DAME OF SPOUSES y l ' SPOUSE SOCIAL SEC, '
OFFICE USE ONLY J
DATE RECEIVED 1 ��� CASH _ eHr# j/I _ A*Pr_RivPn nv