HomeMy WebLinkAboutSLC UTILITIES RECEIPTM ST. LUCIE CO T' iU'
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St. Lucie Count - PCIS
,yy 02-07-2017 �13:51:12 ACCT. # / 5
15365//6101
f PPlHOENIX REAO�TY �OM IF SERVICE ADD
FORTDPIERCE INE ERE CT
rL 34949
Amount Tendered: 6,039.00
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Amount Paid: 16,039.00 E
Change Due: 0,00 L
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SS 7AO. BOX 728 FT. PIERCE. FL 34982
PHONE User ID: HURRAYA MOVE IN/CLOSBQG DATE
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This application hereby request and authorizes the Utility to render water and/or sewage disposal
rz tA"dz0je_CC' '1 U services to the premises described above in accordance with the Utilities present or future rates,
LATERAL({gpyj1 ales and regulations, which by reference are made a part of this contract. Applicant agrees to pay
'-" v' ✓ / . �� .TOTAL the Utility promptly. for such services in accordance with the established rules and regulations.
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CUSTOMERS DEPOSITS ARE NONNEGOTIABLE ORTRANSFERABLE.
CUSTOMER / / // j \, J/ �OCIAL SEC/ ;)
SIGNATURE %fj r.�(/ 2r...� i Ccrc -�„�,. �<,. FAD ID � tQ
NAME OF SPOUSE SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED I I�ARH_ CH4 # RECEIVED13Y 9 �