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ST,MICIE CO:UNT`Y.UTILITIES :P O.B I07X 728 'FT.PIERCE,FL 349.82
St. Lucie County - PCIS
08-07-2015 01 :24:44 ACcI
15832(018
HOLT, ROBt T SERVICE ADDRESS .
6103 BIRCH DR
FORT PIERCE
FL 34982
Amount Tendered: 519.00
=SUBDIVISION XOT _ .. BLOCK
Amount Paid: 519.00
Change Due: 0.00 ,
Thank YouL�L� V 0
User ID: WARDD -.4-7'9-7 •MOVE-IN/CLOSING DATE
^This apphicahon hereby request and gut honzes'the Utility.to render water and/or sewage disposal;
! r r, °""` services to the premises",described above in accordance.with the Utilities present or future._rates;;
'w LATERpI rules.aad regulafions,:.which by.,refere,nce are made a part of thus contract..Applicant agtees to:pay
the Utility proiriptly for such services m accordance with the 6s is rules and regulations:
190 TOTAL,
7_5" ,•, CUSTOMERS:DEPOSITS RRE NON NEGOTIABLE OR TRANSFERABLE ; -
CUSTOM)rR SOCIAL SECT . .
SIGNA' URE
NAME OF SPOUSE : SPOUSE SOCIAL SEC.
l OFFICE USE.ONLY ` J
DATE RECEIVED l .r / fCASH CHK# f RECEIVED BYL
RECEIVED AUG 0 7 2015