HomeMy WebLinkAboutInspection Docs ST LUCIE COUNTY UTILITIES PA BOX 728 FT.PIERCE FL 34982
NAME or oft
St. Lucie County - PCIS /
10-31-2016 12:48:10 AccT
16433/5122 EP SERVICE ADDIZEss 69
TOMKO, MARK -7
5408 SILVER OAK DR
FORT PIERCES j C
FL 34982 SUBDIVISION`: LOT 1 . BLOCK
ME
BILLING ADDRESS
Amount Tendered: 86.50 ALL.
Amount Paid: 86.50 -
Change
6.50 Chance Due: PHONE'#7 j � 7 MOVE.IN/CLOSING DATE
0.00
Thank You This appli"a ion_Hereby request;and authorizes the-Utility to render water and/or sewage disposal-
services_to the-.premises.descrili ed above:in accordance with the Utilities present.or future rates,
rules and re"gulations,°which by reference are made a part of this contract Applicant agrees to pay.
Jser ID: 4VARDD the Utility promptly for:such services in-.accordance with he estabhshed.rules and regulations.
SCUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE..
SOCIAL SEC/1,
FED ID .
SPOUSE SOCIAL SEC
OFFICE USE ONLY
DATE RECEIVED`{! / CASH CHK# / RECEIVED By
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PGRi-AITIT IP4G
t. Lucie County, FL