HomeMy WebLinkAboutSLC UTILITIES RECEIPTSCANNED
BY
St. Lucie County
ST. LUCIE COUNTY UTILIT/yIES BOX 728 FT. PIERCE FL 34982
PCIS
1-�P.O.
NAME biis) / Ib r li ��i
St. Lucie CauntY03 22.05
05-13-2D19
ACCT. #
1705516478
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SERVICE ADDRESS .:✓f 390��Cw/
5239 OwLWD LAKE CIR LOT 52
� eur Al 3gg67
FORT PIERCE
FL 34951
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N�I.U,
3UBDIVISIO'013d �(.Ke FST LOT BLOCK
BOB .00
Tendered:
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BILLINGADDRESS I `i 5 / ' � �11'�l L W r- �/II(�: s3Yt�
Amount
11J� s r iL�I�Y J h, � 33VO/
Amount Paid:
a
-
PHONE # i(J — /�/J 5 / MOVE IN/CLOSING
Change Due:
DATE
_
Thank YOU
'.his application hereby request and authoriies the Utility to render water and/or sewage disposal
orvices to the premises described above in accordance with the Utilities present or future rates,
—
— RDDRIGUEZM
ID :
des and regulations, which by reference are made a part of this contract. Applicant agrees to pay
: Utility promptly for such services in accordance with the established rules and regulations.
JSTOMERS DEPOSITS
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ARE NON NEGOTIABLE OR TRANSFERABLE.
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SOCIAL SEC/Jr�z /3/73<QO
FED ID
NAM
SPOUSE SOCIAL SEC.
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DATE RECEIVED .J
t OFFICE USE ONLY 1_
1�CASH _.`_ ,',Cl1K pt IJ� ECEIVED BY