HomeMy WebLinkAboutADM 97-10 Safekeeping document Request 2017Treasurer’s Tracking #________
Revised 3-16-17
DOCUMENT SAFEKEEPING REQUEST
To: TREASURER’S OFFICE Date: August 17, 2017
From: Development Services, Tristan Weems Contact Phone: 1-530-538-2953
Subject: Transmittal of Document(s) for Safekeeping in the Treasurer’s Vault
Document (circle one): Performance Bond / Surety Bond / Bank Deposit / Irrevocable Letter of Credit
Other: Continuation Certificate
Document Number: Bond No. 783440C Project(s)/Permit(s): ADM 97-10
Dollar Amount: 2,000 APN: 039-560-008
Document Date: 08/09/2017 Property Owner/Principal: Tony and Christine Nunes on behalf of Antonio and Anna Nunes
Maturity Date: 03/23/2018
Renewal Terms: Annual Purpose: Temporary Mobile Home Removal Deposit
Non-renewal Notice Period: N/A Bank/Surety Company: Developers Surety and Indemnity Company
Authorized for safekeeping by:
Signature Date Name and Title
Acknowledgement of Receipt by Treasurer’s Office:
Authorized Signature Date Name and Title
Release Authorized By:
Tristan Weems, Assistant Planner
Signature Date Name and Title
Received By:
Signature Date Name and Title
Instructions: Do not combine different types of documents on one form. Bring original document with this form. Retain a copy of the original documents with a copy of this form showing the tracking number assigned by Treasurer’s Office.