HomeMy WebLinkAboutMisc Letters WATER' " COMM ST.LUCIE COUNTY UTILITIES-P.O.BOX 728 FT.PIERCE.FL 34982
:SEWER` x RES: NAME L LCQ1_Y.}b �.
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--^ rj01 SECURITY DEP SERVICE ADDRESS-
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DDRESS SERVICE FEE..
SAME-DAY FEE l �? ILI
SUBL?IVISION �-c�Y -� ..LOT.. �BLtiCK .::J
OVERTIME FEE
RES ING S ADDRES
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CFC/SEWER
GUAR.REV. 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,
LATERAL rules and regulations,which by reference are made a part of this contract.Applicant agrees to pay
TOTAL the Utility promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
0
USTOMERSOCIAL SEC/
IGNATCTRE A�k_,J.AnFED ID t
[AME OF SPOUSE. SPOUSE SOCIAL SEC.
OFFICE USE ONLY
DATE RECEIVED CASH �-° - t' # /S - RECEIVED BY
ST WaEUfILITIES DEP
2300 VIRGINA AVE
FORT PIERCE,FL 34982
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tai Code: 08512C � � -c�Cl, moi-..M -��` -'� }
Method: dip Read cno -�BME
Issuer .
AMOUNT $519,44
CUSTOMER COPY