HomeMy WebLinkAboutSLC UTILITIES RECEIPTSt. Lucie County - PCIS
11-01-2018 11:02:13
17065/6604
PORT ST LUCI PROPE
5713 MYRTLE DR
FORT PIERCE
FL 34982
Amount Tendered: 519.00
it Paid: 519.00
Change Due: 0.00
Thank You
User ID: RODRIGUEZM
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DATE RECEIVED
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ST. LUCIE COUNTY {UT'IELITIES - P.O. BOX 728, FT. PIERCE �FL 34982
NAME Pry, "1 `7 -� LVC , C NOW
ACCT. # f -70b ]�
SERVICE ADDRESS ��
) (0 �) f ( ��_
— County
SUBDIVISION T f�E LOT (2C BLOCK 60
BILLING ADDRESS C
PHONE # 19 L �3 `' Q0 MOVE IN/CLOSING DATE
This application hereby request and authorises the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay
the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
/ SOCIAL SEC/ ` ( 1 5 � I ) / ��
FED ID `�'�
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
CASH CHK # I RECEIVED BY
COMM
RE/cS-
METER SZ.
ERR
�6
SECURITY DEP
$
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
2) Lf e v (D METER INSTALL..I
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
,LATERAL
TOTAL
CUSTOMER /
SIGNATURE ',
NAME OF SPOUSE
DATE RECEIVED p 0
M
�T LUCIE COUNTY UTTIILITIES - P.O. BOX 7208 FT.
aPPIERCE FL 34982 -
,TAME [ f C• N L C cc, 1 Y�. t�-
A,CCT. # ! i 0 6 (0 `" cc) .
SERVICE ADDRESS 5 t 'l 0 -4` �A P
SUBDMSION LOT V'` s--BLOCK
BILLING ADDRESS
9' �(- � L
`�`�
PHONE # a t"r C1 — &P MOVE IN/CLOSING DATE
This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay
the Utility promptly for such services in accordance with the established rules and regulations.
r•TTc'r W4'PR C nF.POSITS ARE NON NEGOTIABLE ORTRANSFERABLE.
SOCIAL SEC/ 0 � f
FED ID
C
SPOUSE SOCIAL SEC.
OFFICE USE ONLY ��„
CASH_
CHK # I U V I RECEIVED BY �'
ac4 %
�ero
11N6 0
oulyt,
s
St. Lucie County Health Department
M5 5150 NW Milner Dr PortSaint Lucie, FL 34983
HEALTH
PAYING ON: PERMIT #: 56-SF-1875286 BILL Doc #:56-BID-3958369 CONSTRUCTION APPLICATION #: AP1362973
RECEIVED FROM: Alexander J Piazza PSM, Inc. AMOUNT PAID: $ 515.00
PAYMENT.FORM: CREDIT CARD PAYMENT DATE: 09/06/2018
MAIL TO: Thomas & Michelle Lobrutto
SCANNED
BY
St Lucie County �
FACILITY NAME:
PROPERTY LOCATION:
5713 Myrtle Dr
Fort Pierce, FL 34982
29 60
Lot: Block:
Property ID: 3402-609-0307-000-4 1
EXPLANATION or DESCRIPTION:
128 - OSTDS Construction System Inspection Research Fee
-1 - Surcharge (All)
-1 - OSTDS New Permit Surcharge
-1 - OSTDS Construction Application and Plan Review,New
123 - OSTDS Construction Site Evaluation
126 - OSTDS Construction Permit (New or Mod, Amendment)
127 - OSTDS Construction System Inspection
133 - OSTDS Construction Reinspection
rJ11ANTITV FFF
1 $
5.00
1 $
15.00
1 $
100.00
1 $
10i.00
1 $
115.00
1 $
55.00
1 $
7$.00
1 $
56.00
RECEIVED BY: WhighamJL AUDIT CONTROL NO. 56-PID-3701368