HomeMy WebLinkAboutST LUCIE COUNTY UTILITIESMANNED .
BY
( ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL 34982.
NAME
St.
St . Lu201ci
' County = . PCIS ..
8 12:17:07 AccT #
SS s
1705
6445
RYAN HOMq
P. ,! SERVICE ADDRESS 7
5344 OAK@D
LAKE CIR LOT 13
FORT PIER
-
FL 34951
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Amount Te
dered : 608.00 �E SUBDIVISION LOT 'BLOCK
Amount Pa
E
1d; 608.00 BILLING ADDRESS
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Change Du
0`.00
Thank You
U,
PHONE # 1 MOVE IN/CLOSING DATE
User ID:
MURRAYA
r This application hereby requesi and authoriics;the°Utility to,render watei :and/or sewage disposal
services to the premises described above in accordance with -the Utilities, present or future rates,
tiJ+awsAn.•wNW. UaJJM- +.v _
rules and'regulations, which by reference are made a part of this contract. Applicant agrees to pay
V • �! �1�t the Utility'promptly for such'services in accordance with .the established rules .and regulations.
TOTAL CUSTOMERS DEPOSITS ARE NONNEGOTIABLE OR TRANSFERABLE.
CUSTO
SIGNA
ER .' ;SOCIAL SEC% -
- •
M G� L04rC ' FED ID
Fl _
NAME
SPOUSE 'SPOUSE SOCIAL SEC.
OFFICE USE ONLY i
DATE.RECEIVED CASH CHK # RECEIVED BY ,(_
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