HomeMy WebLinkAboutSLC UTILITIES RECEIPTWATER
SEWER'
METER SZ.
RES
M/F
ERR
$ �� SECURITY DEP
SERVICE FEE
SAME DAY FEE
r r OVERTIME FEE
METER INSTALL.
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
$ �ii`1 TOTAL
CUSTOMER
NAME OF SPOUSE
ACCT. # � 1U r" ('19N Kj SOARED
SERVICE ADDRESS �(- By
6T. C1e County
SUBDMSION :r�2-� LOT_ -BLOCK
PHONE #,, - / %2- ?.w - A cal '? 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 futurerates,
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/ G� / y�
FED ID - iG ! ' / 9 aL�
SPOUSE SOCIAL
DATE RECEIVED') (0) 1 CASH OFFICE USECONLY
}
RECEIVED BY_irlil
St. Lucie Countyy - PCIS
05-15-201/9 03:25:00
HOHETEC CONTRACTOR
5302 HICKORY
FORT PIERCE
FL 34982
Amount Tendered: 519.00
Amount Paid: 519.00
Change Due: 0.00
Thank You
User ID: HURRAYA
JUN 0 6 2019
ST. Lucie ermitting
numelq� wl
c IMY
LIL0 0
,:x fM —
Cc
w
$ $
O
y
U O
O
O
O
O
O
O
O
N
d
•O
O
O
O
O
O
O
O}
9
Q O
Q M N
00
O
6
O
O
O
O
O
a m
.`p F a
Q
0
o
`Q
J
fA
{A
Z
m
N
j^ m m
(A
a
IV
L
i m
QfCI
N
N
N
N
N
N
N
V
O
m Yl
m
^
•
OO
i^ Z J t=�
O
O O f1% E r
.0
O
C
- F
?
b N
O
V Yl a .s
O
`
C
C
V
o
V
G2
c
Q r
J
Q
O
a
L]
fo
p; .�
o
N
m
N ci�--
HOMETEC CONTRACTORS INC
Florida Depadment of Health in St Lucia County
�-30
® LMP1OO M/P CHECK
2109
S)/O)jr
f 996 °�` -'---
f Xk,
RECEIVED
JUN 06 2019
ST. Lucie County, Permitting
A