HomeMy WebLinkAboutNEW RESIDENTIAL SERVICE APPLICATIONCITY OF PORT ST. LUCIE.UTILITY SYSTEMS DEPARTMENT
NEW RESIDENTIAL SERVICE APPLICATION
Sprinkler System ❑ Yes ❑ No
027061 "- 819790
By -Pass Softener ❑ Yes ❑ No
Customer -Account t
:r i ,o
DEC 29m.
WATER Capacity: (One ERQ:
$1380.00 r
Account Name: KATHLEEN SMITH YANCY
NON SAD/USA Line Fee;
$ 711.00 ..
;Y
-Service. Address: 581.BEACH AVENUE . , ..-
�„
SAD/USA < M eter Fee:
$
NON SAD%USA Y." Meter Fee:
$ ' 621:Oi)
CPtu: PORT ST, LUCI E. State:° FL . Zi : 349524324: " .
TOTALWATER:
$ _
v�
SEWER.Capacity: (One bRC):
$:
-Mailing Address: 4217 SUNRISE BOULEVARD FORT PIERCE FL 34982=6973
NON. SAD/USA Unefee:
$ FD. 00 �-
13rinder.lnstallation:
$ C,3. M.
LPS Installation Fee:
: Primary Phone #: (772) 4t-`3743 - Secondary Phoriie#:. =
Septic Service:.
`
$.
I.D. # .*********8320
TOTALSEWER:
$.
Security.Deposit Water:
$. 50.00 :.
Security Deposit Sewer:
$
Recording Fee:
$
Leaal Description: LOT.16-BLK 18 RIVER PARK'UNIT-2
LEssDEI?OSIT& REco DINS
$
TOTAL AMOUNT DUE:
Cycle. 01 Book: 013..
❑ Cash ❑ CreditCard:- .Check
# i004
Zone•.. NON
_
Plante.
RECEIPT.#: 0273274 DATE PAID: 12/27/2017 BY:. MICHELLEL
UTILITY will provide water and/or sewer service upon peymenf of the applicable connection charges and cornpllance with the Terms and Conditions listed on the back of this Service Applicatlon:'The Utility policies provide for a water
. and /or wastewater plant capacity allocation of two hundred and fifty (250) gallons per day equivalenfresidentlal connection (ERC). The Utility will not be obligated to provide capacity of service in excess of the allocation and may
require consumer to curtail use which -exceeds such allocated capacity. I have read and acknowledge receipt of this Service Agreement by signature below.
1-2,
2 7 t.
Customer Sitliatur
Date
City of Port St Lucie Utility Systems
121 SW Port St. Lucie Blvd
Port St. Lucie, FL 34984
(772)871-5330
Utlity@cityofpsl.com
s
12/27/2017 1 RECEIPT #: 0273274
Customer - Account: 1027061- 8
KATHLEEN YANCY
581 BEACH AVENUE
Deposit Paid - Water
Miscellaneous
Subtotal
Total
TENDERED
Check #1004
Total
Change
Remaining Balance
)790
$50.00
52,712.00
�2,762,00
$2,762.00
32,762.00
i2,762.00
$0.00
•$2,762.00