HomeMy WebLinkAboutST LUCIE COUTNY UTILITIESST LUCIE UTILITIES DEP
2300 VIRGINA AVE
FORT PIERCE, FL 34982
03106/2018
13:26:15
CREDIT CARD
MC SALE
Card 4 MM=7565
Chip Card: MASTERCARD
AID: A0000000041010
ATC:
015
0
TC: 2AF83E717DAD6405
SEQ
30
Batch 9:
840
INVOICE
30
Approval Code:
087119
Entry Method:
Chip Read
Mode;
Issuer
Tax Amount:
$0.00
Cust Code:
SALE AMOUNT
$176,25
CUSTOMER COPY
`-�-.90N.12& FT PIERCE, FL-44�k-
COMM LUClEi,.,.OUNT.Yuttiiit§,-',,�.'PO .
v9t
'NA- -F M
Te
SERVICEA.,., :31 lat.
DRESS:' 43-
11M.
ECUjj,ry DEP
ERVICETER.,
I AME DAY FEE ,
7
K
LOT UBDIVI§'!Oiq I _BLACK
VERTIME FEE
tER INSTALL':
BILLING ADDRESS
BILL
k/WATER
PHONEW,,.". MOVE IN/CLOSING DATE.
REV.;
This applidaiii6A hereby reilu6t, and'authohi6s the Utility to render water and/or sews ' '7ge'diso'
future
AR
services to thb prernises described above in accoidihce With the Utilities present or rates;
rules.and"i I t which by rdfeiencd,ard made a part of this contract:' Applidant ag.kees to pay
regulations; i9ps, w 4'
,kTER.�L
-6 � IL d established k and re Ations.
the Utility 'pfoniptfy* for such services in . accordance with the establish -rules n regulations.
OTAL
CUSTOMERS DEPOSITS ARE 140iq !qEdOTIABLt OR,tkAN8FIIRABLt.
SOCIAL SEC/
FED ID'.
OFFICEUSEONLY.
CASH CHK# 'RECEIVED BY
'7-
4914946ad
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