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St. Lucie Count - PCIS
07-15-201977 . 1�1:55:07
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P70%rJgT8L6CI PROPE
5713
SEAGR�PE
FORT PIEERC
FL 34982
Amount Tendered:
519.00
Amount Paid:
519.00
Change Due:
0.00
Thank You
User ID: MURRAYA
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ST: LUCIE COUNTY U ILITIES - P.O. BOX 728 ` FT. PIERCE FL 34982,
NAME ��11�T' �� / l%G #Di )A
AcCr /7Ul� S
"SERVICE'ADDRESS% 5�� ✓'
SUBDIVISION_Z� ( LOT' „51LJ BLOCK
L •BILLING ADDRESS
#L7 Z' c2 'CEOR 'MOVEIN/CLOSING DATE
lication herebyrequest:arid:authorizes,the-Utility to render water and/or sewage disposal
to.the piemises.descnbed aboye in accordanmwith the Utilities presentor future rates,
regulations, which by r'eference are made a part of this contract. Applicant agrees to pay
y promptly:for'such services n aecOidahce with the establishe'-rules and regulations.
TERS DEPOSITS ARH NON NEGOTIABLE OR TRANSFERABLE.
SOCIAL SEC/
FED ID
SPOUSE SOCIAL SEC..