HomeMy WebLinkAboutSLC UTILITIES RECEIPTSSt. Luoie County - PCIS
11-26-2018 09:48:59
17055/6494
RYAN HONES
5275 OAKLAND LAKE CIR LOT 61
FORT PIERCE
FL 34951
Amount Tendered: 606.00
Amount Paid: 603.00
0.00
Change Due:
Thank You
user ID: RODRIGUEZM
NAME
DEC 0 9 2018
SST: Luc��ie County,_PermiEEine
TIES - P.O. BOX 728 FT. PIERCE,
r v Gu-1G( Ct- cfe-aounty
SERVICE ADDRESS J`a�5 '"' �'
SUBDIVISIola- Y tb lit �( (r'�LOT' `e) BLOCK
�a b 1l--k.e.PAL'1C >IQC� �
BILLINGADDRESS - -
PHONE #]q �, Q Dn _, J "5J I MOVE IN/CLOSING DATE
This application hereby request and authorizes the Utility to render water and/or sewage: d s)
services to: the premises described above in accordance with the Utilities present or future I
rules and regulations, which by reference are made a-partof this ,eontract. Applicant agreestc
the Utility promptly for such secvices,in accordance with the established rules and regulal
CUSTOMERS DEPOSITS ARRNON NEGOTIABLE OR rTRANSFERABLE.
SOCIAL SEC/ r��-•- I ;�7`..�i_�U sf�
:FED ID
SPOUSE SOCIAL SEC:
,��. CASH - - CHK # V " r ( RECEIVED
v
K
Y WATER
Comm
&RES
o
c �lySEWER
J
i 1�'MEI TER SZ..
M/F
IRR
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SECURITY DEP
'
SERVICEFEE
SAME DAY FEE
OVERTIME FEE
METER INSTALL.
CFC/WATER
FPUA CFC
=^ CFC/SEWER
CUSTOMER
SIGNATURE
NAME OF SPOUSE
GUAR REV.
LATERAL
CC TOTAL
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NAME. i-JUICU'1
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SERVICE ADDRESS 59 -yku i, � bLIL`r LO-L
ga_ r 1 cc --
SUBDIVISION...-{ ' 1101 �k tJ}R6' t" LOT v ' ] BLOCK
BILLINGADDRESS H-CR? ! �11' �L✓L �L C3�UC � � ENO
PHONE i �' a�� r MOVE IN/CLOSING DATE
This application hereby request and authoriies the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates,
rulesand 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 NONNEGOTIABLE OR TRANSFERABLE.
FEDSOCIALSEC/
FED
ID
SPOUSE SOCIAL .SEC.
CASH CHK # v ' ' ' RECEIVED
SCANNED
BY
St. Lucie County - PCIS SF Lucie County
11-26-2018 09:48:59
17055/6494
RYAN HOMES
5275 OAKLAND LAKE CIR LOT 61
FORT PIERCE
FL 34951
Amount Tendered: 608.00
Amount Paid: 608.00
Change Due: 0.00
Thank You
User ID: RODRIGUEZM