HomeMy WebLinkAboutSLC UTILITIES RECEIPTS A
ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL 34982
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NAME 've
15542�3338
IDAMS HoM S OF NOR
ACCT. # X5(-Qr
1504 WATERSTONE BLVD
ORT PIERCE
L 34951 )EP
SERVICE ADDRESS
nount Tendered: 174.00 E
FEE
lount Paid: 174.00
SUBDIVISION I& Ye/--f _hl,'Y LOT-6 BLOCK
ange Due: 0.00 FEE
ink You ;TALL.
BILLINGADDRESS SCANNED
R
ir ID: MURRAYA
By
Lude CoUntv
PHONE# St. MOVE IN/CLOSING DATE
ER
This application hereby request and authoriies 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
f
the Utility promptly for such services in accordance with the established rules and regulations.
TRANSFERABLE.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR
CUSTOME�- Y"'
SOCIAL SEC/
SIGNATURE_ Z�A
FED ID
NAME OF SPOUSE
SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVE CASH CHK# J-J5)ie7'1 RFCEIVEDBYA7t[