HomeMy WebLinkAboutS_Check_Request_MM_Wetlands_LUA13-001568_20250702AP Check Request Form
City of Renton - Finance Department
1055 South Grady Way — 5th Floor
Renton, WA 98057
FinanceAP@rentonwa.Rov
Instructions: Use this form for all payment requests including: employee reimbursements, customer refunds, or recording wire or EFT payments
Check Information
Stacy Tucker 7282 CED/Economic Development
Requestor's Name Ext.
Conner Homes at Piper's Bluff, LLC
Vendor # Payable To
Refund 5-year Wetland M&M cash surety
Check Description
12600 SE 38th Street, Suite 250 Bellevue
Requestor's Department/Division
7/2/2025
Date
23,450.00
WA
Total Check Amount
Address for Check City State Zip
U Employee Reimbursement
Customer Refund
❑ Wire/EFT Payments (if wire attach instructions)
Wire/EFT Date
Other
650.000000.000237.00.00.000
GL Account Number to Charge
GL Account Number to Charge
GL Account Number to Charge
GL Account Number to Charge
Notes/Comments/Check handling instructions:
CHECK REQUEST REFUND FOR 5-YEAR WETLAND MAINTENANCE
AND MONITORING - PIPER'S BLUFF / LUA13-001568
1-1 Emergency Check (outside normal check run)
Date Needed
$ 23,450.00
Amount
Amount
Amount
Amount
GL Account Number to Charge Amount
Matthew Herrera
rIII IMU IVtl111C
BILLING INVOICE EGO0154727
DEPARTMENT: System Administrator
AR:
Eden Invoice:
BILLING CONTACT
Charlie Conner
CHG SF LLC dba Conner Homes at Piper's Bluff LLC
12600 SE 38th St, Suite 250
Bellevue, WA 98006
REFERENCE NUMBER FEE NAME
`\S Y
9FNT�
1055 South Grady Way, Renton, WA 98057
Transaction Date: July 02, 2025
TRANSACTION PAYMENT AMOUNT PAID
TYPE METHOD
Check #483
Plan LUA13-001568 Wetland - Install, Maintain & Monitor
- Cash
Bond Release
Refund Finance AP
3954 (650.000000.000.237.00.00.000)
$23,450.00
23,450.00
SUB TOTAL
$23,450.00
TOTAL
Printed On: July 02, 2025 Prepared By: Stacy Tucker
Page 1 of 1
SPECIAL DEPOSIT TRANSMITTAL
PAYEE: s j1 I Q, —
REFUNDING ADDRESS:
CITY: Ak . STATE: `�' ` ZIP:
PROJECT NAME: �1
ADDRESS LOCATION:
PERMIT#: d. N1
DEPT, CONTACT:
.E• ' (Ld
SPECIAL DEPOSIT CONDITIONS:
V
EXTN: x Z
- _42-
DNISIONSIDEVELOPAEMOVV&P N inCbLDG DEPT. TOIVASSVa5C. BUILDING aDl. Tt W` r SLSPEC. DEPOSIT
WWTE AND YELLOW TO FINANCE RETAIN PINK FOR POP'N RECORDS
DATE:
RECEIPT #:
FINANCE REC. #:
AMOUNT: $_ '� iC • r
WO#: FUNCTION #:
TYPE OF DEPOSIT:
BUILDING
❑ 90 DAY TEMPORARY OCCUPANCY PERMIT
❑ LANDSCAPING MAINTENANCE
❑ SIGN DEPOSIT
❑ STREET CLEANING
PUBLIC WORKS
❑PW CONSTRUCTION PERMIT
PROPERTY SERVICES
❑ LATE COMER FEE (TO BE RETURNED TO LCS HOLDER)
❑ STVAC (APPRAISAL FEE DUE APPRAISER)
BOARD OF PUBLIC WORKS
❑ BPWDEF (BPW DEFFERAL)
(WO# 89150 FN# 5190 TRANS CODE #7054)
❑ OTHER:
Billing Invoice_ EG00028629
Check Number: 483
BILLING CONTACT
D City of
O
Department:
AR:
Eden Invoice:
CHARLIE CONNER
CHG SF LLC dba CONNER HOMES AT PIPER'S BLUFF LLC
846 108Th Ave Ne , #200
Bellevue, WA 98004
Phone: (425) 646-4433
REFERENCE NUMBER
FEE NAME / GL Number Amount Due
Check #483
Plan LUA13-001568 Maintenance & Monitoring - Cash
$23,450.00
3954
SUB TOTAL $23,450.00
TOTAL.- $23,450.00
7
i
E�•OP•Q�DC+•rf+IXi ;�a`l• , • .f THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER •:a• .••_
Conner Homes at Piper's Bluff, LLC Wells Fargo
846 108th Ave NE 355 S. Grady Way
Renton, WA 98057
Bellevue, WA 98004
425-455-9280
DATE CHECK NO
September 18, 2014 483
Pay: ***********Twenty-three thousand four hundred fifty dollars and no cents
PAY City of Renton
TO THE
ORDER OF
i THE BACK OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK —HOLD AT AN ANGLE TO VIEWh
19-854
AMOUNT
$*****23,450.00
Created On: 9/19/2014 8:28:09AM Prepared By: Stacy Tucker 425-430-7282 Page 1 of 1