HomeMy WebLinkAboutProject Information 5t. Lucie County - PUTIL ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL 34982
10-12-2021 04:23:02 ** Bryan Longworth
21409/4915 NAME
FORT PIEH BRYAN 02` 4 � _ 14� �5 FART PIERCE ACCT.# '
34982
Amount Tendered: 519.00 SERVICE ADDRESS 5806 Raintree Trail, Fort Pierce, FL 34982
Amount Paid: 519.00
Change Due: 0.00 V
Thank You SUBDIVISION IRE LOT BLOCK
User ID: MURRAYA 5806 Raintree Trail, Fort Pierce, FL 34982
BILLING ADDRESS
twitterblong@gmailcom
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• CFC/WATER EMAIL ADDRESS: •
FPUA CFC PHONE# 772-237-1586 MOVE IN/CLOSING DATE 5/14/1999
CFC/SEWER
GUAR. REV. 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
LATERAL and regulations, which by reference are made a part of this contract. Applicant agrees to pay Utility
$ $519 TOTAL promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER
SIGNATURE** ` ** Withheld to protect against identity theft
SOCIAL SEC/FED ID
NAME OF SPOUSE
Jessica Longworth SPOUSE SOCIAL SEC. Withheld to protect against identity theft
o
OFFICE USE ONLY Vim.
O ^j M
r' c p 0
DATE RECEIVED CASH CHK# RECEIVED BY o
_✓ I acknowledge Base Facility Charges beginning for water,and/ or wastewater on the day the meter and/or service is installed by
the County, regardless of when a customer connects to or starts utilizing the meter and/or service.
I acknowledge upon activation of service, I will be billed and am obligated to pay the Base Facility Charges.