HomeMy WebLinkAboutUtility FeeSt. Lucie County - PCIS
08-18-2017 08:59:53
6787/6185
D.R. HORTON
3112 YELLOWSTONE CIR LOT 112
FORT PIERCE
FL 34945
Amount Tendered: 174.00
Amount Paid: 174.00
Change Due: 0.00
Thank You
User ID: RODRIGUEZM
DATE RECEIVED,
St. Lucie County - PCIS
08-18-2017 09:00:28
6787/6186
D.R. HORTON
3116 YELLOWSTONE CIR LOT 113
FORT PIERCE
FL 34945
Amount Tendered: 174.00
Amount Paid: 174.00
Change Due: 0.00
Thank You
User ID: RODRIGUEZM
FEE
FEE
RECEIVED BY I Y i-
SlL9Jla➢�' I.VUl\ 1 x V 11xfiiir.+a
NAME I r _"; r�
ACCT. # f i'
SERVICE ADDRESS %C ' ' �f1f "* j'
PHONE # MOVE IN/CLOSING DATE
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
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 M %
CASH
NAME '
ACCT. #
SERVICE ADDRESS -
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
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 �/ CASH RECEIVED BY
WATER
Comm
SEWER
1RES
J ! b METER SZ.
M/F
IRR
$ [ �!
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL.
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
j�
$ v
TOTAL
CUSTOMER
SIGNATURE r—
NAME OF SPOUSE
DATE
/70&- 03 57
ACCT. # 1.4 1 [ A / — 6
SERVICE ADDRESS 3 (f a V ellai
SUBDIVISION I 1 J0 J —LOT BLOCK
BILLINGAD RESS IL41 I/
�
3'�
c�
PHONE # MOVE IN/CLOSING DATE
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
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. 10
OFFICE USE ONLY
CASH VW c,
RECEIVED BY. M_ le
Y