HomeMy WebLinkAboutRECIEPTt . SEWER
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SECURITY DEP
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SERVICE FEE
SAMEDAY FEE
OVERMIEFEE
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CFC/WATER
FPUA CFC
CFC/SEWER
GUAR REV.
LATERAL
AME OF SPOUSE.
DATE
ST LUCIECOUNTy,UTHXjUS P.O.,
; 728 FT PRIER—M FL 34982
NAME '
ACCT #.'`�"
This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises:described above in accordancemith,the Utilities present or future rates,
Hiles and regulations, which by reference are made a part of this contract. Applicant agrees to pay
the Utility promptly tor such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSTFS.ARE NON NEGOTIABLE OR TRANSFERABLE.
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SPOUSE SOCIAL
UFFICE USE ONLY G
CASH - CHK # p�
SCANNED
BY
St. Lucie Counts
St. Lucie County - PCIS
10-1e-2019 02:38:49
ADAMSS OMES069 0F NOR
5607 PALM DR LOT 39
FORT PIERCE
FL 34982
Amount Tendered; 519.00
Amount Pald:
519.00
Change Due;
0.00
Thank You