HomeMy WebLinkAboutSLC UTILITIES RECEIPT✓ WATER
SEWER
METER SZ.
'�... "" M
RES
M/F
r IRR
SECURITY DEP
SERVICE FEE
SAME DAY FEE
, II OVERTIME FEE
METERINSTALL.'
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR_ REV.
LATERAL
$ 4 I TOTAL
CUSTOMER
NAME OF SPOUSE
M��
ACCT. # C?L4 V 7 " 6901 09d1I�IVIVUM
SERVICEADDRESS 4ir. yo (4 St. Lucie County
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MR
PHONE A / /� �� %� — 2 ct / MOVE IN/CLOSING DATE
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/ 9%r
FEDID _�3- /0 9 - /
SPOUSE SOCIAL
OFFICE USE ONLY
DATE RECEIVED CASH CHK # 71119 RECEIVED EY7W
St. Lucie Count - PCIS
05-15-2019 63:23:17
HOMETEC C NTRACTOR
5110 BIRCH
FORT PIERCE
FL 34982
Amount Tendered: 519.00
Amount Paid: 519.00
Change Due: 0.00
Thank You
User ID: MURRAYA
JUN 06 2019
ST. Lucie County, Permitting