HomeMy WebLinkAboutUTILITIES—T LUCIE UTILITIES DEP -
2300 VIRGINA AVE
WATER.
FORT PIERCE:, FL 34962
_ 07,11 2018
SEWER _
D METER SZ.
Card r
SEQ #:
INVOICE
APProval Code:
Entry Method:
Mode;
Tax Amount;
Cust Code:
Avs Code;
Card Code:
SALE AMOUNT
(tu1T CARD
MC SALE
XXXXXXXYXXXX7474
15
929
15
019271
Manual
Online
$0.00
S �10 3T OMER COPY
CUSTOMER
SIGNATURE
NAME OF SPOUSE
NNN
M
$176.25
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2V9 J
44/ 1�-C- LOT BLOCK
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6-1 a MOVE IN/CLOSING DATE
ereby request and authorizes the Utility to render water and/or sewage disposal
;mises described above in accordance with the Utilities present or future rates,
ms, which by reference are made a part of this contract: Applicant agrees to pay
itly for such services in accordance with the established rules and regulations.
EPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL
FED IDSEC/ 17- n / /
SPOUSE SOCIAL SEC. I
OFFICE ZSE ONLY
DATE RECEIVED. �!' ,�� CASH # MLA RECEIVED BY
RECEIVED
MAR
P@rMittin9 Depar ol-«..
St.
011
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