HomeMy WebLinkAboutMisc Letters SLLITIES DEP af;; sT.LiJCIE C.O.UNTY UTILITIES..'P.O..BOX 728,FT.'PIERCE,EL 34982
2300 VIRGINA AVE
FORT PIERCE,FL 34982 N,e,
112712016 10:55;05
CREDIT CARD {{ ACCT
F a
VISA SALE
Mrd# 0000(}0=5217
iip Card: Visa Credit -
lD: AOOODO00031010 i.'
TC: 0038 jy SUBDIVIsIo
C: 6C5D6B1A2CB35FB8
EQ#: 4 + BLLLII�TG'ADDRESS `� +1;,+GAY 7
atch# 510
VOICE 4 'Biu
pproval Code: 907255 �ZMOVEIN/CLOSING DATE
nh•y-Method: Chip Read
lode: Issuer
( This application hereby request and authorizes the Utility to render water and/or ewage,disposal.;
C services to the premises described above in accordance with the Utilities present or future rates,
;ALE AMOUNT $521.25 E1�L`' ; Hiles and regulations,which by reference are made a part of this,contracf.Applicant agree to pay
the Utthty promptly:for such services in accordance with the established rules:and regulations_. -
'AL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE.OR TRANSFERABLE
EC/
CUSTOMER COPY soclAl.s
SPOUSE SOCIAL SEC
OFFICE USE'ONLY
DATE RECEIVED �I CASH SIk RECENED BY`