HomeMy WebLinkAboutUtility Receipt C ST.LUCIE COUNTY UTILITIES-P.O.'PrOX 728.FT.PIERCE,FL 34982
RES NAME V rI"a
St.. Lucie County - PC
05' 19-2017 03:51:,to ACCT.#
678 6128 �, SERVICEADDRESS
D.R. HORT
8505 COBBLESTONE DR f �,eT� 2giK
FORT PIERCE
FL'34945 SUBDIVISION CJ - LOT T BLOCK
Amount Tendered: . 176.25 BILLING D SS 1 ✓�-� '�"
Amount Paid:. 176.25
Change Due: 0.00 PHONE# MOVE INICLOSING DATE
Thank You This application hereby request and authorises 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
User ID: RODRIGUEZM the Utility promptly for such services in accordance ivith-the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC
/ � a (t Lot-,FED ID
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED CASH CHK# RECEIVED BY V
Y