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12357529
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Last modified
9/5/2024 1:13:38 PM
Creation date
9/3/2024 10:18:38 AM
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Permits
Permit Address
34897 NORTH FORK RD
Permit City
Lyons
Permit Number
555-21-007762-PRMT
Parcel Number
084E31 00100
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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AutIvantiction113z728131398118C48.495040AMIE9004MOBSE <br /> tpo C71 I:136 Ra Box 444 <br /> ttE t n(11 rmil'a falai It1 ry 013 97 I <br /> AS413 SEPTIC SERVICE <br /> one Li n5 on d Maititcri'd!lt.e <br /> Bradford Green October 13,2021 <br /> 1?.303 Pinehurst Way <br /> Seattle;WA 98125 REG:34897 North,Fork Rd.,Lyons <br /> Payment for the 2 yr..Service Contract for theATT system n being lostalledattheabove referencertsite <br /> address shall be Paid by signee Bradford Green .The service contract will be billed out at <br /> time of Start Up"and the contract riatesmill:begin.once.sySterwit-tUrned on for use.Signee,has;agreed <br /> to be the responsible party for the balance owed at the above address..Accounta-pre clue and payable <br /> within 10,days,Should signeenot e issued a nAlternative Treatment Technology septic permit by <br /> Marion county this.Promise to Pelletier will bevoid. <br /> Name:. Rreciforriā¢Green PLEASE SIGN <br /> killientitzto <br /> Signature: gkadiefut qui 8; RETURNt <br /> ' Par <br /> Address: 12303-Pinehurst.Way NE <br /> Seaftle WA 9A1 <br /> Phone 4: 206=9794503 <br />
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