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12022546
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12022546
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Last modified
1/29/2024 10:10:49 AM
Creation date
1/25/2024 3:33:42 PM
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Permits
Permit Address
17085 WALL LN SE
Permit City
Jefferson
Permit Number
555-22-000657-PRMT
Parcel Number
103W13AA00300
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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SEPTIC • <br /> flfiB SERVICE Invoice <br /> P.O. Box 444 <br /> Albany, OR 97321 <br /> Invoice# 54895 <br /> Date: 2/22/2022 <br /> Terms: Net 30 <br /> J.A. HOLLAND CONSTRUCTION, LLC. Due Date: 3/24/2022 <br /> 4943 WAGON TRAIL CT <br /> SALEM, OR 97317 <br /> 17085 WALL LANE SE <br /> Service Address: JEFFERSON,OR 97352 <br /> Units Description Rate Serviced Amount <br /> 1 PUMPED 900 GALLONS FROM TANK 400.00 2/21/2022 400.00 <br /> FOR ABANDONMENT <br /> W/O#37069 <br /> Invoice Total $400.00 <br /> Thank you for choosing us, we appreciate your business. <br /> If paying by Credit Card please circle which card type and <br /> write your card number in the space below or call our office. <br /> 1-866-927-1156 <br /> REMITTANCE ADVICE - PLEASE RETURN WITH YOUR PAYMENT <br /> Service Address: 17085 WALL LANE SE. JEFFERSON <br /> Invoice# 54895 <br /> A & B Septic Service Date: 2/22/2022 <br /> Terms: Net 30 <br /> P.O. Box 444 <br /> Albany, OR 97321 Card Type: (Please Circle Below) <br /> Visa / Mastercard <br /> 1-866-927-1156 Card No: Exp: <br /> Signature: <br /> Total: $400.00 Amount Enclosed: <br />
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