HomeMy WebLinkAboutSt Lucie Utility Fees. Lucie County - PCIS
-19-2018 12:56:29
67-87 6184
08 YELLOWSTONE CIR LOT 111
iRT PIERCE
. 34945
count Tendered: 176.25
count Paid: 176.25
range Due: 0.00
lank You
;or ID: MURRAYA
t LATERAL
I'
P h o� •TOTAL
CUSTOMER
SIGNATURE
[ I ST.
BILLING ADDRESS O" n
PHONE N _�� �_; 5 _,�MOVE IN/CLOSING DATE
This application he request and authorizes the Utility to render water and/or sewage disposal
services to the premises descci6cd 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 NONNEGOTIABLE OR TRANSFERABLE.
r SOCIAL SEC/
FED ID
NAME OF SPOUSE SPOUSE. SOCIAL SEC.
l �} OFFICE USE ONLY /n
DATE RECEIVED? I �� III CASHFI'K`#' li- RECEIVED BYdY V t