HomeMy WebLinkAboutRECEIPTSt. Lucie County - PCIS
10-18-2019 02:38:34
15542/6868
ADAMS HOMES OF NOR
5309 SAN BENEDETTO PL LOT 3
FORT PIERCE
FL 34951
—_int Tendered: 174.00
Amount Paid: 174.00
Change Due: 0.00
Thank You
User ID: WARDD
L.1
NAME
ACCT. #
SERVICE ADDRESS;
�3 v9 s 7
<;t
i' LOT
PHONE # /yS D �C ��_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/
FED ID
SPOUSE SOCIAL SEC.
I OFFICE USE ONLY
DATE RECEIVED (' I S()CASH CHK # .5 �l �� 5 t
RECEIVED
a, EI SCANNED
BY
_; St. Lucie County
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