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���� � ���� `�� � <br /> � �3>��2�.��� _ _ <br /> �.�:. <br /> CASH ASSURANCE DEVICE <br /> SectlOri I- To be completed liytl�e Project Planner <br /> Instrzrctians: Complete Section T and the Assiu•ance Device License. Attach a copy of <br /> estiinate o�'improvements and f�all documents to the Gity Clerk's Office. <br /> Const�lrction Szte Address ��r j ��2���fj�` ��� <br /> Pro ect#,Pro'ect Flanner ��� � UC'�� �'%=E'S� �E f t v� I <br /> .l .l �1��� ' t <br /> Name of7Depositor��'� (,��r��C'�rS ��` /��/��-����''�'Sf �r.�v/r�C.�j� , <br /> Adclress J�%'�7 SY�'L?� �� �Ufif-P �� ��lG'�>� i <br /> / � � <br /> Plione `t ��J �`� ,� ' ���`7 Email ���-f'����1 V✓�O�, G�/'YJ <br /> Check one: i <br /> � Performance (installatioxi) -Not less tha 15�f the cost of the iinprovements o�� <br /> 300%if in a critical area ���OC� JC /S�7�. — ��/l Z�Q" f <br /> ❑ Maintenance =Not less than 10% of estimate of imp�ovements ��, <br /> C Oth�r- i <br /> �; <br /> I' <br /> ( <br /> These fiinds are fio be retained fo•a minimum of �/�' year /m� he.projected ;I <br /> release date is scheduled for �� j� � 'v� �� . �� <br /> —f-• � � <br /> l�/���� : �r�h�'Sca�i,�J ���r.�s� b� ���s %1-���zv��l ���5����� v�a,� �� <br /> .__.-9' `�z�5 �/at�, C<(// �2,5-2�'�-�2�/ � G�rQ�tL��e ihS��z''��. � <br /> Section II - To be coniPleted by the City Clerk's (Of�ce tJ� �-�/�'s % Y"����+�' ;� <br /> ;I <br /> I�ist�•uctiorrs: Gomplete the lower portion when deposit is made and route a copy to the ',�I <br /> Project Planner and fhe Depositoz. <br /> ii <br /> The amount of$ i� /�'"�/U` � was deposited in the Assurailce Deposit '� <br /> �ccoui�t(002-239�1006-000) oii �� �`� �-�'� �' (date of de os�t)., d <br /> This transaction tivas completecl by ��`,!�� x�`���'. <br /> l � ,I. <br /> Note foi�Depositof•:It is yozax�r�esponsiba7zty�to coi���ctct llae PNoje�ct Planne�c�t�le�cst o'fze ��' <br /> montlt prioi°to the reZe�rse clate fo�inspection. <br /> ; <br /> ' <br /> i <br /> Cash Assur•ance Device to the City ofEverett __ __ __� i, <br /> 2930 Wetmore Aveiiue, Suite 8-A o Everett; WA 98201. • 425.257.8731 • fax 425,257,8742 • www.everet[wa.org <br /> I <br /> . i� _ <br /> a� � ) <br />