HomeMy WebLinkAboutUtility Receipt ST.LUCIE:CO 1UNNTY UTILITIES-P.O.h dX 728 FT.PIERCE FL 34982
NAME LJ fTy F
St. Lucie County - PCIS
05-19-2017 03:51:19 ACCT.#
6787 6131 SERVICE ADDRESS
D.R. HORT
8520 COBBLESTONE DR r < e rCQ
FORT.PIERCE SUBDIVISION C.1lau[X LOT f U�
FL 34945 L� f1 �sLocx .
Amount.Tendered:
174.00 BILLING D SS '
Amount Paid: 174.00
Change Due: 0.00 PHONE# MOVE IN/CLOSING DATE
Thank You 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
the Utility promptly for such services in accordance with the established rules'and regulations.
,User ID: RODRIGUEZM CUSTOMERS DEPOSITS ARE NON NE—GOTIABLE OR TRANSFERABLE.
SOCIAL SEC, LPL
FED ID
SPOUSE SOCIAL SEC.
_..._....�--------- OFFICE USE ONLY
DATE RECEIVED CASH CHK# RECEIVED BY
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