HomeMy WebLinkAboutUtility Receipt ST.LUCIE COUNTY UTILIZES-P.O.�)ox 728 Yr.PIERCE FL 34982
St. Lucie County - PCIS NAME 4V F 1
05-19-2017 03:50;57 ACCT# '"'"' 'tot
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678 6132 SERVICEADDRESS C _(.)q . 6
D.R. HORTO
8524 COBBLESTONE DR
FORT PIERCE ,
FL 34945• SUBDIVISION LOT BLOCK
Amount Tendered: 174.00 BILLING D ss 1 -
Amount Pald: 174.00 YL 1p)l'fD
Change Due: 0.00 PHONE# MOVE IN/CLOSING 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 with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL
FED ID SEC/ "7 S. R
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED CASH CHK# RECEIVED BY
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MAY
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