HomeMy WebLinkAboutSpecial Deposit TransmittalSPECIAL DEPOSIT TRANSMITTAL
PAYEE: te- nt ,ck'l-or;r 1 �._
Y
REFUNDING ADDRESS:
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IM Lak W96T& `1lNl
CITY: STATE: ZIP:
PROJECT NAME:
ADDRESS LOCATION:
PERMIT #: � � m - 1910 y
DEPT. CONTACT: .l ExTN: �ZZ
SPECIAL DEPOSIT CONDITIONS:
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WHITE AND YELLOW TO FINANCE, RETAIN PINK FOR PBPW RECORDS
DATE: 12 Ct l b
RECEIPT # ' F 6 rrf1c;,_
FINANCE REC. #:
AMOUNT: $ 0
WOM 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:
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RECEIPT EG00058788
BILLING CONTACT
Office at Southport, LLC
1083 Lake Washington Blvd N , 50
Renton, WA 98056
REFERENCE NUMBER FEE NAME
—qdnp�, CITY OF
Benton y�
1055 S Grady Way, Renton, WA 98057
Transaction Date: August 29, 2016
TRANSACTION PAYMENT AMOUNT PAID
TYPE METHOD
CH 5661
Plan LUA00-156 Wetland - Install, Maintain & Monitor -
Cash
Bond Payment
Check #5661
S30,000.00
3954 (660.000000.000.237.00.00.000)
$ 30,000.00
SUB TOTAL
$30,000.00
Office at Southport, LLC
1083 Lake Washington Blvd, N
Suite 50
Renton, WA 98056
(425)282-5933
Pay
r10 The
]rder Of
D(ACfLY THIRTY THOUSAND DOLLARS
City of Renton
1055 S. Grady Way
Renton WA 98057
US Bank
19-10/1250
5661
Date Amount 8
08/24/2016 ******$30,000.00
F
s
B
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tt'566�,rt■ J:125000054 153592G27i2Gits
Printed On: Auqust 29, 2016 Prepared Bv: Stacy Tucker Page 1 of 1