Laserfiche WebLink
CASH ASSURANCE DEVICE <br />SectiOn I- To be completed by thc Project Planner <br />. � -- <br />-- - - --_ _ J�/�7>,� <br />����n� <br />�De ;� ����� <br />� <br />Inslructions: Complete Section I and the Assurance Device License. Attach a copy of <br />estimate of improvements and fax all documents to the City Clerk's Office. <br />Construction Site Address %2 5 S Vv �lP/Yliti WfQ�� �I <br />Project #, Projecl Planner ��GL �'I �ir/7 �i �l�i I � ���i% �Ji/� <br />NameofDepositor lL/1-Pi L!f/��il� c:/���' /r�G • <br />Address 0 25(� 5��1�P 1�1�/�'• 5���(Piy �L (Y�%i,�� <br />Phone �F25 -�1'�3� 533<J Email I r� G l� i hr� � ��o/Br�'U�IIr'Sia�� ��'`'� <br />Check one: <br />❑ Pei%rmance (installation) - Not less than 150% of the cost of the improvements or <br />�300% if in a critical arca �/ 2� <br />Maintenance - Not less than 10% oPestimate of improvements �:� <br />❑ Odier - : <br />These funds are to be retained for a minimum of !� years/months. The projected <br />release date is scheduled for /�/0 dt'/!'1 �� ?Ol3 <br />Section II - To be completed by the City Clcrk's Office <br />I�tstrucfions: Complete the lower portion when deposit is made and route a copy to the <br />Project Planncr and the Depositor. <br />TheamountoF$ �,�jJ�,��J <br />Account(002-239-]006-000) on <br />This trnnsnction was comp(eted by <br />as deposited in the Assurance Deposit <br />I I (date af deposit). <br />,_ _ . .. <br />Note jor Depositor: I! is your responsibility to confact the Project Planner at least one <br />mvnth yrror to tl�c rclease dalc for inspeclion. <br />Cash Assurance Devrce ro the Ci o Everett <br />2930 Wetmore Avenue, Suitc 8-A • Gverett, WA 98201 • 425.2�7.8731 • fax 425.257.8742 • vnvw.everettwa.org <br />