HomeMy WebLinkAboutUtility Cert ST.LUCIE COUNTY UTILITIES-P.O.dX 728 FT.PIERCE FL 34982
NAME LJ
St-.".Lucie. County - PCTS
.05719-2017 03:48:48 ACCE# C� 1/�
B �'— ('0 1 32�•
6787 6133. SERVICE ADDRESS ✓.0
Q.-R. HORTO
8528 COBBLESTONE DR
FORT PIERCE , . - �f,
FL 34945 SUBDIVISION.�Jx LOT I�a. BLOCK
Amount Tendered: 174.00 . BILLING D SS
Amount Paid: 1.74.00
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
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 SEC/" R ( `
FED ID 9
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED CASH. CHK# " RECEIVED BY' '
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MAY 1 t347�e
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