HomeMy WebLinkAboutSLC UTILITIES RECEIPT^'
A WATER
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ST. LUCIE COUNTY UTILITIES - P.O. BOX 728 FT. PIERCE %34982 L;ANN�®
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SECURITY DEP
SERVICE ADDRESS ,"�
SERVICE FEE
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SAME DAY FEE
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BILLING ADDRESS
CFC/WATER
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This application hereby request and authorizes the Utility to render water and/or sewage disposal
LATERAL
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
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$ (COX,
TOTAL
the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SI f
SIGNATURE;; ' A�C�iP
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SOCIAL SEC/ _
FED ID ✓ ��"�--� 7`
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NAME OF SPOUSE
SPOUSE SOCIAL SEC.
;OFFICE USE ONLY � 1�
DATE RECEIVED I " j 7"' CASH CHK #,Q- � `� Q RECEIVED BY./ 1 A
t%c%-F—avLou
NOV 2 0 I018
ST. Lucie County, Permltting
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St. Lucie. Count - PCIS
09-14-2018 �1.27:31
RYANIHOME5646-
F3RT PIERCED TAKE CIR . LOT 73
FL 34951
Amount Tendered: 608.00
Amount Paid: 608.00
Change Due: 0.00
Thank You
j User ID: MURRAYA