HomeMy WebLinkAboutSLC UTILITIES RECEIPTIV WATER Comm
Y SEWER RES
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CFCNVATER
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CFC/SEWER
GUAR REV. 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,
LATERAL, rules and regulations, which by referenceare made a part of this contract Applicant agrees to pay
$ (al /I • U U TOTAL me Utility promptly for such services in accordance with the established rules and regulations.
_ CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER � I SOCIALSEC/ ��,
SIGNATURE l�:.V',{nJ�i.��,��—✓l��r •1. FED ID `y- U
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NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVE CASH) CHK#�/l2- RECEIVEDBY ./�yli.t i�
APR I J'i9
ST. Lucie County,
SCANNED
BY
St. Lucie County
I
St, Lucie Count - PCIS
03-29-2019 69:33:15
1705MM5 6468
52N5 OAKLAND LAKE CIR LOT 46
FL 34951RCE
Amount Tendered: 608.00
s Amount Paid: 608.00
Change Due: 0.00
Thank You
User ID: MURRAYA