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g M� St. Lul_ie County - PCIS
06-28-2018 09:00:.03
$ 6787/6246
D.R. HORTON
8701 COBBLESTONE DR LOT 36
FORT PIERCE
FL 34945
Amount Tendered: 174.00
Amount Paid: 174.00
Change Due: 0.00
Thank You
$ ; User ID: RODRIGUEZM
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SIGNATUR;
NAME OF
DATE RECEIVED; V CASH
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OUNTY UTILITIES- P.O. BOX 728 .FT. P
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MOVE IN/CLOSING DATE
�ation hereby request and authorizes the Utility to render water and/or sewage disposal
the premises described above in accordance with the Utilities present or future rates,
gulahons, which by reference are made a part of this contract. Applicant agrees to pay
promptly for such services in accordance with the established rules and regulations.
RS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/
FED ID
I SPOUSE SOCIAL SEC. 1 �'
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CHK #. RECEIVED BY
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SIGNATURE . , ....
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CIE C6twTvYrUTILITIES P. O BOX 128 FT. PIERCE FL 34982.
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r MOVE IN/CLOSING DATE
on hereby request and auth
�icahorizes the Utility to render water and/or sewage disposal. `,
tq the premises described above �n accordance with the Utilities present oc future rates,:
regulations, which by reference are made a part of'this contract Apphcantagrees to''pay
ylpromptly°for such services m accordance with the estalhshed rules and_regalatons
FRS DEPOSITS,ARE NON NEGOTIABLE OR TRANSFERABLE '
SOCIAL SEC/ ,
`t
FED -ID
SPOUSE SOCIAL SEC
DICE USE ONLY `,
�_ CHK # RECEIVED BY �