HomeMy WebLinkAboutSLC UTILITIES RECEIPTWATER
,:L• SEWER
METER SZ.
Comm
RES'
M/F
DO JRR.
ACCT. # J rI D5 5 — & + D
_ - SERVICE. FEE
,
1t-C.''1. T 4tm u- I R 3 L[qJ I .
SAME DAY FEE
SUBDIVISIO(4-66 W(tt'[[�(L-OT/CX�.�l
OVERTIINSTAL FEE
D
/BLOCKS/p /'l
BILLINO ADDRESS / /- ' l�r r /' L� r(/J�L RIO `^k �7VU
7 ✓�• y METER
CFC/WATER
. 1
p QS7LC �i YI �� 3U70/
/ _1� 1
PHONE N��(UI " %2D "13507 MOVE IN/CLOSING DATE
FPUA CFC
CFC/SEWER
_ -
GUAR.REV:
This application hereby request and autho riies the Utility to render water and/or sewage disposal
- - - - -
- premises describedabove'
services to the . inaccordance with the Utilities present or future rates,
_ .LATERAL
rules and regulations, which by reference are made. apart of this contract. Applicant agrees to pay
the Utility promptly for such services in accordance.with the established rules and regulations.
S. V V TOTAL
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE ORTRANSFERABLE:
CUSTOMER 90CIAL SEC/
SIGNATURE �� ��.J4.
_.(—C A 1k FEDID (IJ
NAME OF SPOUSE SPOUSE SOCIAL SEC.
DATERECEIVED CASH_
O ' W�
St. Lucie County - PCIS
02-20-2019 10:08:45
17055/6490
"Al HOMES
5266 OAKLAND LAKE CIR LOT 29
FORT PIERCE
FL 34951
Amount. Tendered: 608.00
Amount Paid: 608.00
Change Due: 0.00
Thank You
User ID: MURRAYA
SCANNEL.
BY
St. Lucie Count