HomeMy WebLinkAboutSLC UTILITIES RECEIPTWATER COMM ST LUCIE COUNTY UTILITIES P.O. BOX 7281
SEWER Y, RES
,; NAME
METER SZ. M/F
IRR ACCT. #
$ �I f1 SECURITY DEP SERVICE ADDRESS
/ SERVICE FEE
J r
SAME DAY FEE SUBDIVISION , ilb -(1 LOT
" OVERTIME FEE �7� %7 ,'
_7 f METER INSTALL.' BILLING ADDRESS �t-�' { .x-'! �"
CFC/WATER 6(,t.� S � C /,ia' -ki
. PIERCE, FL 34982
J�
FPUA CFC PHONE #'j' J . r! ,� " MOVE IN/CLOSING DATE
CFC/SEWER
GUAR. REV. This application hereby request and authorizes the Utility to render water and/or sewage disposa
services to the premises described above in accordance with the Utilities present or future rates
LATERAL rules and regulations, which by reference are made a part of this'contract. Applicant agrees to pay
t� the Utility promptly for such services in, accordance with the established rules and regulations)
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. 1
CUSTOMER �, SOCIAL SEC/
t_a
SIGNATURE ! t.i' -�\AVC FED ID
NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED �i' -1(( / tl CASH -
#,D, 7D � U RECEIVED BY� .
SCANNED
SCANNED
st ..Lucie Cunt
St. Lucie Countyy - PCIS
09-14-2018 01:30:37
17055//6455
RYAN HOME5
5337 O§AND LAKE CIR LOT 68
FORT PIE CE
FL 34951
Amount Tendered: 608.00
Amount Paid: 608:00
Change Due: 0.00
Thank You
User ID: MURRAYA