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ST LUCIE COUNTY UTILITIES P.O BOX 728,FT CE,FL 34982
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St. Lucie County - PCIS
10-18-2016 11:56:51
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16414/4952 E`P SERVICFi ADtiRESS t � � /1•
S BANK f C
U610 RAINTREE TR J ' ' .1�� �" �� .�
FORT PIERCES
FL 34982 SUBDIVISIONBLO1.
CK
L BILLING
Amount Tendered: 519.00
4''
Amount Paid: 519.00 p j
PHONE#�a MOVE IN/CLOSING DATE
Change Due: 0.00
r
Thank YOU cation. ereby request and authorizes the Utility to render water and/or sewage disposal;
This ippli
serv�ces-to the"premises`descrnbe`d above.m accordance with the Uhhties present oi•.future rates,
i rules and regulations,which by reference are made a part of this cgntract Applicant.agrees to pay.
the Utility promptly for"such services m'accord"'- witTi the established.-rules and regulations
User ID: RODRIGUEZM ! CUSTgMERS DEPOSITS ARE NON NEGOTIABLE OR.TRANSFERABLE
x FED ID `i
SPOUSE SOCIAL SEC
a
I� OFFICE;USE ON'- <
DATE:RECEIVED _ `� I CASH CHK# / RECEIVED BY.4
.... � � l tew'�,f• �'.f S L is <i�- _
RECEIVED
NOV 2 9 2dp6
� CElW E®
r:
NOV 2 9 2®16
PERMITTING
St.Lucie County, FL