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HomeMy WebLinkAboutSLC UTILITIES RECEIPTSt. Lucie County - PCIS 04-25-2019 01:59:59 18719/6761 SYNERGY HOMES LLC 5117 PALMETTO DR FORT PIERCE FL 34982 Amount Tendered: 521.00 Amount Paid: 521.00 Change Due: 0.00 Thank You User ID: RODRIGUEZM ST. LUCIE COUNTY UTILITIES - (P.O. BOX 728 FT. PIERCE FL 34982 NAME UPL{ LC� ACCT. # _ f 1 r� v 1 (; 5 ` �1 1 SERVICE ADDRESS L� YY4- D BILLINGADDRESS /V'� Sg� PHONE' #_J 6 L O by ) 6 MOVE IN/CLOSING DATE oe C' nn e- 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. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. SOCIAL SEC/ �` FED ID _ -I D— I (�C') D I b SPOUSE SOCIAL SEC. OFFICE USE ONLY xDATERECEIVED. cZ� �� CASH' ' CHK# 1