HomeMy WebLinkAboutST LUCIE COUNTY UTILITIES`.�
WATER
SEWER
METER SZ.
10 10:35Dn :56
$ (� 67&/6262
D.R. HORTDN
672E COBBLESTONE DR LOT 52
FORT PIERCE
FL 34945
Amount Tendered: 176.25
Amount Paid: 176.25
Change Due: 0.00
Thank You
User ID: MURRAYA
the Utility
TOTAL G-TTQT('1M
CUSTOMER
SIGNATURE
NAME .OF SPOUSE
FY UT LITIES - P.4
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(Oggl) l `ram
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5D__ BLOCK
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✓J �I l� MOVE IN/CLOSING DATE
by request and authorizes the Utility to render water and/or sewage disposal �
ses described above in accordance with the Utilities present or future rates, d'
which by reference are made a part of this contract. Applicant agrees to pay9
for such services in accordance with the established rules and regulations.
)SITS ARE NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/ '
FED ID
SPOUSE SOCIAL SEC.
4rl�2&119OFFICEUSE ONLYDATE RECEIVEDCASH �# RECEIVED BYNW�