HomeMy WebLinkAboutInspection Docs (2) i
RECEIVED
FEB 2 0 2010
permitting Department
t - ---- Pianning & Development Services St.Lucie Countv
Building & Code Regulation Division
2300 Virginia dive
p<.b 0n R�4 Q >nl .,_ ®yrfr fierce, FL 349982 �7 }��y°� �{y/p
�1���������� Fax �!`�''�Y1'V6.��a9'6$'3
Request for 30-Day Temporary Power Release
Date: e2_1 Permit Number: 70 Project
S --
Project Address:
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY, FOR A PERIOD NOT TO EXCEED THIRTY(30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
` REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
I. This temporary power release is requested for the above stated purpose only,and there will be no
occupancy of any type,other than that permitted by construction during this time period.
2. As witness by our signatures,we hereby agree to abide by all terms and conditions of this agreement,
Including Building Division Policy,which is incorporated herein by reference.
3. All conditions and requirements listed in the attached document entitled"Requirements for 30 Day
Power for Testing"have been fulfilled and the premise is ready for compliance inspection.
4. All requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed from the site and/or a Stop Work Order issued if
the Final Inspection has not been approved within 30 days. A fee of$100.00 will be required to lift
the Stop Work Order.
i WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST.LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION,INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNE IGN DATE
a�
GEN L CbNTRA SIGNATURE DATE
CTRICAL CONTRACTOR SIGNATURE DATE
I
l
I
FILE
0
Planning & Development Services
Building & Code Regulation Division
�. 2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTLON SOIL TREATMENT
PERMIT #: 1767- OB ADDRESS:311 h 6,oSAVy,,e. 0 f,-t 5,-t-A> e3�1�1N5
BUILDER/CONTRACTOR: 2 K 14ortUV\
PEST CONTROL CONTRACTOR: M A-S 5F.� 5 5_7 i2 V-KG S S ,s, W- _
PjEST CONTROL LICENSE #: 7171
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
9,4bre feet if area treated: S Chemicals used: rr s�
f v
Percentage of solution: Total gallons used: /1 (D
Date of Treatment: 2/ Time of Treatment: 9 . )3 ct m
Footing Slab
1st Treatment 1st Treatment
Re-Treat Re-Treat
Driveway Pools
1st Treatment 1st Treatment
Re-Treat Re-Treat
Other Perimeter for Final Inspection
1st Treatment G
Re-Treat
Signature of Exterminator Date
Note: There must be a completed form for each required treatment or re-treatment and this form must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fail and a re-inspection
fee charged.
I
FBC104.2.6 Certificate of Protective Treatment for prevention of termites. A weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed,
providing a copy for the person the permit is issued to and another copy for the building permit files. The Treatment
Certificate shall provide the product used, identity of the applicator, time and date of the treatment, site location, area
treated, chemical used, percent concentration and number of gallons used, to establish a verifiable record of
protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatment shall
be completed prior to final building approval.
St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
I
Revised 7/24/2014 APPROVED
i
• Phone 954-784-2941
800-848-1919
r�� ®� Fax 954-784-7875
V
&TESTING INC. 5 www.fed-eng.com
250 SW 13th Ave Pompano Beach,FL 33069
Field Density Tests of Compacted Soils Method D-6938
Project: Proposed Residence Lot 116, Creekside Date: November 24, 2017
Address: 3117 Yellowstone Circle, Fort Pierce, FL 34945 Order#: 17-DR-1156
Area Tested: Building Pad Permit#:
Material Type: Brown Sand with Some Rock Tech: SL
Client: D.R. Horton, Inc.
I o
Address: 1430 Culver Drive NE Compaction Req.. 95/e
e P
Palm Bay, FL 32907 Proctor Method: ASTM D-1557
Test Probe Moist Dry Proctor Optimum
TEST LOCATION Elev. ° Density Value Moisture Compaction Pass
/O
# Depth PCF PCF
1 Center of Pad 12" FL 9.2 107.2 112.5 11.0 95.3% Yes
2 SW Corner of Pad 12 FL 10.5 106.9 112.5 11.0 95.0/e Yes
3 NE Corner of Pad 12" FL 9.8 108.4 112:5 11.0 96.4% Yes
4
5
6
7
8I
9
10
I
11 �
i
12!
i
13
14
Remarks: See Reverse Side(Page 2 of 2)for Additional Information for Disclaimer
This is a Compaction Test only on the top 12"of the pad and is not a verificatiohr cif Soil Bearing Capacity.
Legend for Elevation:
PR Proofroll 1,2,3= 1st,2nd,3rd Lift Submitted by:,,
SL Springline FL=Final Lift ��Keith,Ledlanc,'f?�E. 0
SG Subgrade BG=Below Grade - Federal En&,,eering& Testing, Inc.
BCi -1'Basecourse BOF=Bottom of Footing -Florida Reg-No.59394
TOP=Top of Pipe FG=Finished Grade -Certifilcate-'o�Authorizatian#^5471
As a imutual protection to clients,the public and ourselves,all reports are submitted as the confidentiar ro�erty of clients,and authorization fob publication of statements,
conclusions or extracts from or regarding our reports is reserved pending our written approval.A density,test datermines the degree of Gpalpaction of the tested layer of
material only.A density does not replace a soil bearing capacity determination.These density tests do not ce"nig,tFe-u6dei,yMg.soil mat's7s"velow the proposed structure.
The results do not preclude or guarantee that future settlement and cracking will not occur.A soil boring test isii�qquired to cerPif that the,underlying soils will support the
proposed structure without settlement. If no soil borings have been performed to verify the underlying soils, 9—oll'6orings be performed to evaluate the
suitability of the underlying soil to support the proposed structure.After laying dormant for a period of 90 days or after tfeavy ral, 4d!ii s,retesting must be performed on this
work!
l' PAGE 1 of 2
I
Compacted Soils Method ®-6938 Disclaimer
Pursuant to your request, Federal Engineering & Testing, Inc. (FET) has performed a compaction test at the referenced
project on the reverse side. The purpose of our test was to determine the degree of compaction of the tested layer of
material only. In no way shall a compaction test replace a soil bearing capacity determination. A soil boring test must be
performed by the client prior to construction to verify subsoil conditions. Our scope of services only included testing the top
12" of added fill material. FET was not contracted to perform supervision of the building pad preparation. This testing of
the added fill material does not include an analysis of the underlying soil materials to determine if they are capable of
supporting the proposed structure without settlement. This density compaction test does not warranty any underlying soil
materials or conditions below the tested top 12 inches of material. If no soil borings have been performed in the location of
the proposed structure, we recommend performing soil borings below all foundation areas of the proposed structure to
verify the underlying soil conditions.
Environmental analysis of the soil materials is not part of the scope of services. If environmental analysis of the soils is
required, we can provide a proposal for performing an environmental analysis of the soil materials. The scope of services is
for determination of the degree of compaction of the tested layer of material only. No other analysis is implied or warranted.
Job project specifications were not available at the time the work was performed. Determination of the pass/fail compaction
results are based on current common industry requirements of 95% of the ASTIVI D-1557 standard for building foundations
and 98% of the AASHTO T-180 standard for paved areas such as roadways and parking lots. If different specifications are
required, Federal Engineering &Testing, Inc. shall be notified.
Our findings are relative to the date and areas of our site work and should not be relied upon to represent conditions on
other areas or dates. Any subsequent site disturbances due to water erosion, rain waters, construction activities,
excavations, overgrown, vegetation, traffic and other disturbances will void this test and the site must be re-compacted and
re-tested prior to construction.
As a mutual protection to clients, the public and ourselves, all reports are submitted are the confidential property of clients
and authorization for use, publication of statements, conclusions or extracts from or regarding our reports is reserved
pending written approval.
It has been a pleasure working with you and we look forward to doing so in the near future.
Page 2 of 2
• Phone 954-784-2941
L i o. ederlbi
800-848-1919
Fax 954-784-7875
8 TESTING INC. www.fed-eng.com
250 SW 13th Ave Pompano Beach,FL 33069
j Field Density Tests of Compacted Soils Method D-6938
Project: Proposed Residence Lot 116;Creekside Date: November 24, 2017
Address: 3117 Yellowstone Circle, Fort Pierce, FL 34945 Order#: 17-DR-1156
Area;Tested: Building.Pad Permit#:
Material Type:. Brown Sand with Some Rock Tech: SL
i
Client: D.R. Horton, Inc.
Add less: 1430 Culver Drive NE Compaction Req.: 95%
Palm Bay, FL 32907 Proctor Method: ASTM D-1557
I
Test Probe Moist Dry Proctor Optimum
# TEST LOCATION Depth Elev. % Density Value Moisture Compaction Pass
PCF PCF %
1 Center of Pad 12" FL 9.2 107.2 112.5 11.0 95.3% Yes
2 1 SW Corner of Pad 12" 1 FL 10.51 106.9 112.5 11.0 95.0% Yes
3 NE Corner of Pad 12" FL 9.8 108.4 112.5 11.0 96.46/o Yes
4
51'
6 �
7
8 ,
I
9 �
I
101
11 �
12
13'
14�
Remarks, See Reverse Side(Page 2 of 2)for Additional Information for Disclaimer
This is a Compaction Test only on the top 12"of the pad and is not a verification.of Soil Bearing Capacity.
Legend for Elevation:
PR-Proofroll 1,2,3= 1st,2nd,3rd Lift Submitted by.`-
SL=Springline FL=Final Lift -Keith-LeBlanc,P.E.
SG Subgrade BG=Below Grade -`,Federal Engineering Testing, Inc.
BC Basecourse BOF=Bottom of Footing .Florida Reg-No.59394
TOPS=Top of Pipe FG=Finished Grade 1 -Certificat2 of Authorization5471
As a mutual protection to clients,the public and ourselves,all reports are submitted as the confidential;nroperty of clients,and authorizatioc for'publication of statements,
conclusions or extracts from or regarding our reports is reserved pending our written approval.A densit'VA61 determines the degree cf ccmpaction of the tested layer of
material only.A density floes not replace a soil bearing capacity determination.These density tests do noYcertify;the-undeii'yingsoil mkerl&�s-below the proposed structure.
The results do not preclude or guarantee that future settlement and cracking will not occur.A soil boring testis required to certi6,tha`,Aae nderlying soils will support the
proposed structure without settlement. If no soil borings have been performed to verify the underlying soils,we-rec6mrneenc7 that E=oil;,borings be performed to evaluate the
suitability of the underlying soil to support the proposed structure.After laying dormant for a period of 90 days or after heavy rainl:,UAs,retesting must be performed on this
work.
I
PAGE 1 of 2
• .
s
Compacted Soils Method D-6936 Disclaimer
Pursuant to your request, Federal Engineering & Testing, Inc. (FET) has performed a compaction test at the referenced
project on the reverse side. The purpose of our test was to determine the degree of compaction of the tested layer of
material only. In no way shall a compaction test replace a soil bearing capacity determination. A soil boring test must be
performed by the client prior to construction to verify subsoil conditions. Our scope of services only included testing the top
12" of added fill material. FET was not contracted to perform supervision of the building pad preparation. This testing of
the added fill material does not include an analysis of the underlying soil materials to determine if they are capable of
supporting the proposed structure without settlement. This density compaction test does not warranty any underlying soil
materials or conditions below the tested top 12 inches of material. If no soil borings have been performed in the location of
the proposed structure, we recommend performing soil borings below all foundation areas of the proposed structure to
verify the underlying soil conditions.
Environmental analysis of the soil materials is not part of the scope of services. If environmental analysis of the soils is
required, we can provide a proposal for performing an environmental analysis of the soil materials. The scope of services is
for determination of the degree of compaction of the tested layer of material only. No other analysis is implied or warranted.
Job project specifications were not available at the time the work was performed. Determination of the pass/fail compaction
results are based on current common industry requirements of 95% of the ASTM D-1557 standard for building foundations
and 98% of the AASHTO T-180 standard for paved areas such as roadways and parking lots. If different specifications are
required, Federal Engineering &Testing, Inc. shall be notified.
Our findings are relative to the date and areas of our site work and should not be relied upon to represent conditions on
other areas or dates. Any subsequent site disturbances due to water erosion, rain waters, construction activities,
excavations, overgrown, vegetation, traffic and other disturbances will void this test and the site must be re-compacted and
re-tested prior to construction.
As a mutual protection to clients, the public and ourselves, all reports are submitted are the confidential property of clients
and authorization for use, publication of statements, conclusions or extracts from or regarding our reports is reserved
pending written approval.
It has been a pleasure working with you and we look forward to doing so in the near future.
_. -
Page
,,
DEC 0 Phone 964-784-2941
ederal PEt;^aill' unty 800-848-1919
St. Lucie County,1 L Fax 954-784 7875
&TESTING INC. www.fed-eng.com
269 sW 13th Ave Pompano Beach,FL 33M
Field Density Tests of Compacted Soils Method D-6938
Project: Proposed Residence Lot 116, Creekside Date: November 24, 2017
Address: 3117 Yellowstone Circle, Fort Pierce, FL 34945 Order#: 17-DR-1156
Are Tested: Building Pad Permit#:1$7y2 — pG /kS'—
Material Type: Brown Sand with Some Rock Tech: SL
Client: D.R. Horton, Inc.
Address: 1430 Culver Drive NE Compaction Req.: 95%
Palm Bay, FL 32907 Proctor Method: ASTM D-1557
Test Probe Moist Dry Proctor Optimum
TEST LOCATION Elev. ° Density Value Moisture Compaction Pass
# Depth �0 PCF PCF %
1 Center of Pad 12" FL 9.2 107.2 112.5 11.0 95.3% Yes
2 SW Comer of Pad 12" 1 FL 1 10.5 106.9 112.5 11.0 95.0% Yes
311 NE Corner of Pad 12" FL 9.8 108.4 112.5 11.0 96.4% Yes
4
5
6
7
8
9
10
' 11
12
I
13
Remarks: See Reverse Side(Page 2 of 2 for Additional Information for Disclaimer %C, s
This is a Compaction Test only on the top 12"of the pad and is not a verification of S jng Ca aci i
Legend for Elevation: / = 0.
PR Proofroll 1,2,3=1st,2nd,3rd Lift Submitted by: /
SL Springtime FL=Final Lift Keith LeBlanc,Pity-0 ; StPTWf,7 r,5�
SG=Subgrade BG=Below Grade Federal Engineer �sting�lnc. P�
BC I Basecourse BOF=Bottom of Footing Florida Reg.No.594 LOR1Q•• co,
/.� ---
TOP=Top of Pipe FG=Finished Grade Certificate of Authorizdn ���L
As a,mutual protection to clients,the public and ourselves,all reports are submitted as the confidential property of clients,and authorizatio py� flgn,�f �rhents,
conclusions or extracts from or regarding our reports is reserved pending our written approval.A density test determines the degree of compactio Ihhkk s ad layer of i
material only.A density does not replace a soil bearing capacity determination.These density tests do not certify the underlying soil materials below the proposed structure.
The results do not preclude or guarantee that future settlement and cracking will not occur.A soil boring test Is required to certify that the underlying soils will support the i
proposed structure without settlement.If no soil borings have been performed to verify the underlying soils,we recommend that soil borings be performed to evaluate the
suitability of the underlying soil to support the proposed structure.After laying dormant for a period of 90 days or after heavy rain/storms,retesting must be performed on this
work'.
PAGE 1 of 2
Compacted Soils Method D-6938 Disclaimer
Pursuant to your request, Federal Engineering & Testing, Inc. (FET) has performed a compaction test at the referenced
project on the reverse side. The purpose of our test was to determine the degree of compaction of the tested layer of
material only. In no way shall a compaction test replace a soil bearing capacity determination. A soil boring test must be
performed by the client prior to construction to verify subsoil conditions. Our scope of services only included testing the top
12" of added fill material. FET was not contracted to perform supervision of the building pad preparation. This testing of
the added fill material does not include an analysis of the underlying soil materials to determine if they are capable of
supporting the proposed structure without settlement. This density compaction test does not warranty any underlying soil
materials or conditions below the tested top 12 inches of material. If no soil borings have been performed in the location of
the proposed structure, we recommend performing soil borings below all foundation areas of the proposed structure to
verify the underlying soil conditions.
Environmental analysis of the soil materials is not part of the scope of services. If environmental analysis of the soils is
required, we can provide a proposal for performing an environmental analysis of the soil materials. The scope of services is
for determination of the degree of compaction of the tested layer of material only. No other analysis is implied or warranted.
Job project specifications were not available at the time the work was performed. Determination of the pass/fail compaction
results are based on current common industry requirements of 95% of the ASTM D-1557 standard for building foundations
and 98% of the AASHTO T-180 standard for paved areas such as roadways and parking lots. If different specifications are
required, Federal Engineering&Testing, Inc. shall be notified.
Our findings are relative to the date and areas of our site work and should not be relied upon to represent conditions on
other areas or dates. Any subsequent site disturbances due to water erosion, rain waters, construction activities,
excavations, overgrown, vegetation, traffic and other disturbances will void this test and the site must be re-compacted and
re-tested prior to construction.
As a mutual protection to clients, the public and ourselves, all reports are submitted are the confidential property of clients
and authorization for use, publication of statements, conclusions or extracts from or regarding our reports is reserved
pending written approval.
It has been a pleasure working with you and we look forward to doing so in the near future.
Page 2 of 2
Phone 954-784-2941
L i ederit-
800-848-1919
Fax 954-784-7875.
8 TESTING INC. WWW.fed-eng.com
250 SW 13th Ave Pompano Beach,FL 33069
Field Density Tests of Compacted Soils Method D-6938
Project: Proposed Residence Lot 116, Creekside Date: November 24,2017
Address: 3117 Yellowstone Circle, Fort-Pierce, FL 34945 Order#: 17-DR-1156
Area Tested:' Building Pad Permit#: 1767— /
Material Type: Brown Sand with Some Rock Tech: SL
Client: D.R. Horton, Inc.
Address; 1430 Culver Drive NE Compaction Req.: 95%,
Palm Bay, FL 32907 Proctor Method: ASTM D-1557
Test I Probe Moist Dry Proctor Optimum
TEST LOCATION Elev. Density Value Moisture Compaction Pass
# Depth %
p PCF PCF %
1 ICenter of Pad 12". FL. 9.2 107.2 112.5 11.0 95.3% Yes
2 :SW Corner of Pad 12" FL 10.5 106.9 112.5 1 11.0 95.0% Yes
3 kE Corner of Pad 12" FL 9.8 108.4 112.5 11.0 96.4% Yes
4
5
6
7
8
9
10
12
i
13i
14
Remarks: see Reverse Side(Page 2 of 2)for Additional Information for Disclaimer
j This is a Compaction Test only on the top 12"of the pad and is not a verifidatityri of^aril Bearing Capacity.
Legend for Elevation: iov
PR=1 Proofroll 1,2,3=1st,2nd,3rd Lift Submitted by:
SL=lSpringline FL=Final Lift ` Keith\LeBlanc,Pd: . - ` r 7f/t7
SG;Subgrade BG=Below Grade - Federal,Erygifle�;ring&T_ f g, In
BC=Basecourse BOF=Bottom of Footing Florida Reg.-No.59394
TOP-Top of Pipe FG=Finished Grade Certifri;atei cif_Agt orizatiori e;z 471 I`
Copy
As a mutual protection to clients,the public and ourselves,all reports are submitted as the confidential'proriPrty of clients,and authorization,faC publication of statements,
conclusions or extracts from or regarding our reports is reserved pending our written approval.A density,te� atemiines the degree Jf,c?mpaction of the tested layer of
material only.A density does not replace a soil bearing capacity determination.These density tests do not,ce.rfify the undErlyfnd sblfTate als-below the proposed structure.
The results do not preclude or guarantee that future settlement and cracking will not occur.A soil boring test'is'r¢4u'.rs .to cerri5j-fhat'the'underlying soils will support the
proposed structure without settlement. If no soil borings have been performed to verify the underlying soils,we recommend.that soil borings be performed to evaluate the
suitability of the underlying soil to support the proposed structure.After laying dormant for a period of 90 days or after heavy73la"16torms,retesting must be performed on this
work.i
PAGE 1"of 2
I
Compacted Soils Method D-6936 Disclaimer
Pursuant to your request, Federal Engineering & Testing, Inc. (FET) has performed a compaction test at the referenced
project on the reverse side. The purpose of our test was to determine the degree of compaction of the tested layer of
material only,In no way shall a compaction test replace a soil bearing capacity determination. A soil boring test must be
performed by the client prior to construction to verify subsoil conditions. Our scope of services only included testing the top
12" of added fill material. FET was not contracted to perform supervision of the building pad preparation. This testing of
the added fill material does not include an analysis of the underlying soil materials to determine if they are capable of
supporting the proposed structure without settlement. This density compaction test does not warranty any underlying soil
materials or conditions below the tested top 12 inches of material. If no soil borings have been performed in the location of
the proposed structure, we recommend performing soil borings below all foundation areas of the proposed structure to
verify the underlying soil conditions.
Environmental analysis of the soil materials is not part of the scope of services. If environmental analysis of the soils is
required, we can provide a proposal for performing an environmental analysis of the soil materials. The scope of services is
for determination of the degree of compaction of the tested layer of material only. No other analysis is implied or warranted.
Job project specifications were not available at the time the work was performed. Determination of the pass/fail compaction
results are based on current common industry requirements of 95% of the ASTM D-1557 standard for building foundations
and 98% of the AASHTO T-180 standard for paved areas such as roadways and parking lots. If different specifications are
required, Federal Engineering &Testing, Inc. shall be notified.
Our findings are relative to the date and areas of our site work and should not be relied upon to represent conditions on
other areas or dates. Any subsequent site disturbances due to water erosion, rain waters, construction activities,
excavations, overgrown, vegetation, traffic and other disturbances will void this test and the site must be re-compacted and
re-tested prior to construction.
As a mutual protection to clients, the public and ourselves, all reports are submitted are the confidential property of clients
and authorization for use, publication of statements, conclusions or extracts from or regarding our reports is reserved
pending written approval.
It has been a pleasure working with you and we look forward to doing so in the near future.
Page 2 of 2
..... .....
9 f Ail
18
41"
LC
iL
ST LUCIE COUNTY UTILITIES-P.O.BOX 728,FT.PIERCE.FL 34982
� NAME
5t, Lucie County - PCIS s
:59:00 --
f
08-18-201 08 7 ACCT•#�• • .." � [.�'' ;it � �" (.�' i�
6787/6188
Ep SERVICE ADDRESS
D.R. HORTON
3117 YELLOWSTONE CIR LOT 116
FORT PIERCE E Ow"'VS, J fFL 34945 SUBDIVISION, LOT ( f BLOCK
�E ( f 3 •'
Amount Tendered: 174.00 L . BILLING-ADI7RESS '4-
� 174.00 �. � r . ��• �,� f�
Amount Paid:
� �1 _��,- r
- -�4
0.00 'i
Change Due" i 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/
FED ID
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED � �I CASH �' IfVI RECEIVED BY UV 1.
,,� tam ,�,,k •.... „,.: _
ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE FL 34982
NAME
St� Lucie County - PCIS
1
08 18-2017 08:59:22 { ACCT.#
6767/6190 p SERVICE ADDRESS
D.R. HORTON f
31d9 YELLOWSTONE CIR LOT 118
FORT PIERCE •....
FL 34945 j Sl BDIVISION LOT / BLOCK
` BILLING A�DRESS Amount Tendered: 174.00
J �:
Amount Paid: 174.00
i PHONE# MOVE IN/CLOSING DATE
Change Due: 0.00
i
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 i
the Utility promptly for such services in accordance with the established rules and regulations.
User ID: RODRIGUEZM CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/
FED ID
i
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED— �� CASH QRW; �� RECEIVED BY E��` �