HomeMy WebLinkAboutProject Information ST.-LUCIE.COUNTY UTILITIES.-P.O.BOX 728,FT.`P-IERCE,FL 34982
St. Lucie CoulPCIS
RECEIV'-:D MAR 04 2a �v,�
03-04-2016 08:27:02 / �
ACCT,# ;L
16103 4157
HESSEE CLAUDIA SERVICEADD,. `t aSSS Off,
5420 CASSIA DR
FOR34982RCE �—J �� Jt�
Amount Tendered: 519.00 -" 'ID-a- ! I
I SUBDIVISION /� LOT BLOCK
Amount Paid: 519.00 L BILLINGADDRESS
Change Due: 0.00 J !� .
Thank You F 1 l� 3 g
f PHONE.# �� � �3 MOW IN/CL OSING"DATE
User ID: WARDD
This application; ereby request and authorizes the Utihtyao render water and/or'sewage disposal
;.,,. .. .0 _....,: ..,,..1 services,to the premisesescribed 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
the Utility promptly for such :` iservices in;accordance with•the'estahhshed.rules and regulations..
TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE
,CUSTOMER ^. � S^ SOCIAL SEC/
SIGNATURE G> � ` `.s�Q�l— 'FED ID g' � 5
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NAME OF SPOUSE SPOUSE SOCIAL SEC.
. :
OFFICE
RECEIVED
ONLY
DATE:RECEIVED /� CASH CHK# � RECEIVED BY` G�