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HomeMy WebLinkAboutSLC UTILITIES RECEIPTK WATER CON I SEWER RES i I j C/ { ✓� j �D METER SZ. M/F 0 d ; IRR $ J ! U / SECURITY DEP l SERVICE FEE 1: 'SAME DAY FEE I' OVERTIME FEE -3 Lr L�� METER INSTALL. ' � CFC/WATER 1 FPUA CFC I, I' CFC/SEWER ST. LUCIE COUNTY UTILITIjE (S �- P.O. BOX NAME. ACCT. # SERVICE ADDRESS ff � '& 1� P it t 3 l SUBDIVISIOJ1k101 q W4 1 LOT BLOCK BILLINGADDRESS 1450 'Lei'llrG, -PkJd _. 311J(' -e Sf+ a :LOPS-1 prim EEC,►"? ,,-N .355 M 1 . PHONE #...91)1 — 1190 - _1_?�% MOVE IN/CLOSING DATE GUAR. REV. This application hereby request and authorizes the Utility to render water and/or sewage disp • services to the premises described above in accordance with the Utilities present or future r. LATERAL rules and regulations, which by reference are made a part of this contract. Applicant agrees to Idll the Utility promptly for such services in accordance with the established rules and regulati l c / 1 ! TOTAL. • CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. CUSTOMER` \ r SOCIAL SEC/ SIGNATURE 1 `,(,Jl�\ �a ' TC-' 0I C� FED ID 0�! 4 I. NAME OF SPOUSE SPOUSE-SO'IAL'SEC. ✓ z f DATE RECEIVED ! .a h 1 DASH OFFICE USE i CHK #✓ d 3 3 (� RECEIVED RECEIVE® NOV 2 01019 06h' ltt"19 nepartment St. County t St. Lucie County - PCIS 10-09-2018 03:53:10 17055/6495 RYAN HOMES 527E OAKLAND LAKE CIR LOT 26 FORT PIERCE FL 34951 Amount Tendered: 608.00 Amount Paid: 606.00 Change Due: 0.00 Thank You User ID: RODRIGUEZM