HomeMy WebLinkAboutSLC Utilities ReceiptSt. Lucie County - PCIS
06-24-2019 - 02:39:39
15542/6948
ADAMS HOMES OF NOR
5811 BALSAM DR LOT 18
FORT PIERCE
FL 34982
Amount Tendered: 519.00
Amount Paid: 519.00
Change Due: 0.00
Thank You
User ID: WARDD
DATE RECEIVED
".. t-, "' k�l`6' .•,*� -2 ti J' J� 2sai r s r J' — _ i -yP
Tf�UC YUT ITIES BOX 728 FT PIERCE FL 34982
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iACCT #
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,SERVICE ADDRES
+� fE SUBDIVISION � ;. : " LOT f °' BLOCK _
`` BILL GADDRESS "Lc�
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PHONEz, ,� MOVE INICLOSING DATE..,
This application hereby request and authorizes the Utility to:render water and/or sewage disp'osal
services to the premises described above m accordance with the Utihhes present or>future rates;
rules and r`,egulahons, which by reference are'made a part of this contract Applicant agrees to pay:'.
the Utility promptly for such services m accordance wrthahe established riles and:regulationsY.;
CUSTOMERS DEPOSITS ARE NONNEGOTIABLE OR TRANSFERABIE
SOCIAL SEC/
FEDID
f SPOUSE SOCIAL -SEC.
r OFFICE USE ONLY %
CASH CHK # /CEIYED BY
RECEIVED
AUG 14 2019
ST. Lucie County, Permitting