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Home My WebLink AboutBond Form for Plant Restoration - PLN General - 12/9/2005 �l Dq '4 MASON COUNTY BOND FORM Type of Permit:_ _ FK V 1I''D N W+e-M+llq j Name: C hterlc.5 Qhd Cant v eraer a rrarrl'ed CovP l e. Type of Improvement: P l ayif Q e,5-b rd1'OV1 Project Location: 'f)"7 (3ecU''Gre�eK DeWat)V Rd 1 Bgl Fair WA_ Legal Description of Property: Pa.rce) J 2-3 o9 —31 --7 o o-7-3 ; 1.-or 3 o F ShoKt Plot- at-t3 ur {yeek wat Rd Belfiflrl W4 With reference to the above-identified matter, this will certify that this institution has a savings account(or loan) for the above-referenced owner/developer/contractor for the project so identified. In consideration of the permitted improvement,and in lieu of a performance bond, this institution hereby agrees that it will freeze the following sums of money for the indicated improvement pending written authorization)for release of said funds by in the amount of$ Q o f V6 _ Dollars. The total sum indicated will be withheld by this institution from any disbursements of any kind until written authorization has been received by this institution from Mason Coimty to release the sum of money indicated by the written.authorization from the County. The design,location,materials and other specifications for the indicated improvement are those required by Mason County as appears in the above-referenced document/permit, and shall be incompliance with the Mason County Resource Ordinance, Chapter 8.52 Mason County Code as amended. These funds shall be held by the institution for a period of three years. In the event that Ch rles +CQYTZ to (responsible party's name)does not comply with the aforementioned requirements, Mason County may demand, and the institution shall make,payment to Mason County of said funds so that the necessary repairs can be performed immediately to Mason County standards. The institution shall not be liable to C LOGS t er (responsible party's name) for any disbursement of said funds to Mason County."The conditions in this agreement may only be amended or revoked by express written condition of Mason County. Signature of Responsible Party Date Confidential Page 1 Form Revised:03/25/03 Z©/ZB 39Vd 00dVWIQ TSZZ69LO96 Eb:ZI 900Z/Z1/10 Accepted: Name of Bank/Ph e Number C�D3�'�C�srBsa� Approved: Title: -6 c/ __ Bank Address I — Date ()C0r1qbq13(Da193 Account Number STATE OF ,— County of (Individual Acknowledgement) Notary Public in and for the State of VimlL�, residing at do hereby certify that on this day of LUW24 dO S ., personally appeared before me me luiown to be the indivi ual described herein and who c ut this instrument and acknowledged that a-aAko signed and sealed the same as free and voluntary act and deed for the uses and purposes herein mentioned. GIVEN UNDER MY b AND OFFICIAL SEAL this day of 20� •• Notary blic in an for the to of , residing at oc� � ►diLlQn ,�gLB�:in said .� County. My Commission ex Tres My Commission Expires July 9, 2 Confidential Page 2 l±omi Revised:03/25/03 Z0jT�3 ��d OO�IbWIQ T5ZZ69L09£ £b �ZL 900Z/ZT!Z j M"ON Coin BOND Foy i Typc ofPa7ujt: Name: .. Typo of Tn4n0ve umt: Pita-r � 2{?g-t-jS2 N Project Loeatiom a E�a(rL �8�D�cr3p�tou ofPt erty: Qa c. t 230q-31-9 007 3: LOT St•tona- PLAIT- 2-r}36 DP-FQ-cAAeEt~ b o� With rMsrence to the above idanttS4d nester,this wi11 celtil y that t}tis institution has: e accoemt(or loan)ftar&e abova-reffteacod owncr/dVelopWv nUWtor Sor@be pmaect so idend$t& In considenation of the permitted.impmvemenr,tuud in lieu of a Petfomawce jODd,this ind tation hereby agrees that it will Steens tho folkM ipg s«s of money for the indicated v=ettt Pending written 8nthot'iZttt for relaasc of said Am& by in the ainount of ! �►� Dollars The tatat stud a3dicated will he-withheld by ibis kwatutlon ftm any disbu vmnew of- any land until writtcO au$iorizatlon has been rcoeivM by this institution fmm Mammon County to release the MM of moaiey hxhcaW by the writteu MWWdz9'0n f nm the copy. The dcaiSa+ Iocadiom;Materials and Other spycations for tbo indicated vinprovement are those req by Ma*on County as Vpeats in dncAnn and shall by ut.complumco with the Mason County Resource OnMunce, " ter cnrn12 Masan C-ou auty Code as am ndcd The"ftutds shall be bald by the institution for a Puivd of thraaa yam. In the evtrit t11at _C�►.1lit� U..ISJLL'},k .. (responsibie parry's game)does trot comply wi.@t the quit& eats,1' "On Couxtty may demand, and the institution shall nuke,Payment to MWbn CoUnty of said fugds so t1W dw necessary repairs can be Performed kmcdi ately to Mason County staadards. The institution shall not be liable to M _(zesponst'ble party'a narne)for any disbtu�scment of Said funds to Meson City. The con&dotis in this AM=cut may outy be ran=Kled or revoked by exprsss wri�en condition of Mason County. g — — Signature ofRespoaeill#Patty D s ate Coat Pit • i �Rid:d32gpp zoo 90/z0 39va 00dvHIQ TSZ369L09E SZ:TT S00ZWT/60 i �l�C¢p?�C1: �_ 4 i Name of nank P' mw Numbct • �App�v� �� C Tide.. Z O -7-E54k `re,.Styes-'r�fie Bmk Addmm --2- Acaount Namber STATE OF WASIINGTON, Cotmty of, Oh&vi"Ackwwjedgcment) NoWy Public ia and for the Stara Of Wa4r ngton,residlug at do hereby certify that on t2tis 1� day 20-0� pm0nally app=ed before to the lmowtt to be the individual descxlbed hraoin W wbo examted this hwm meat and acknowlodgod that nip signed and sealed rho same as Y fire and vnl=L14wy act and deed for the uses sad purposes herein menlionc& GIVEN UNDER MY HAND AND QFFWIAL SEAL this day of Za-C-%A,;:;L Notary public in as far tits State of residing at in said ,igRt H�` County. M Cammiaeion explre9 ff AvOu hr �on6dea�al . Page 2 Farm R&vim&-03aSM CUD� wS di•nn nn..�. 50/60 �Jt7d O��it7WIQ TSZZ69L096 SZ :TT S00Z/ZT/60� 4 1 MASON COUNTY BOND FORM Type of Permit: . i=NV N &AL Name: _ Type of Improvement: Project Location: B E��2 ��Asc,.;; ��•,�,�-;c� Legal Description of Property; PAS t 23 0q-3 _9 St-forzr P I.AT� 2 3' nor 3 of 't36 BrR(L Cf2,eer_ bQU-y-NTo t2D 10-CLFRt2 1AJA&R. S� 2- With reference to the above-identified matter, this will that savings account(or loan)for the above-referenced owner/developer/contractorc institution rthea project so identified. In consideration of the Performance bond,this institution hereby permitted improvement,and in lieu of a Y a ing that it will freeze the following sums of money for the indicated improvement pending written funds by in the amount of$ authorization for release of said c IC tt� !A V'J bR.FD Dollars. The total sum indicated will be withheld by this institution from any disbursements of any kind until written authorization has been received by this institution from Mason County to release the sum of money indicated by the written County. authorization from the The design, location,materials and other those required by Mason Coun specifications for theindicated improvement are and shall be incompliance with the Mason Cin o above-referenced documenUpermit, Mason County Code as amended ounty Resource ordinance, Chapter 8.52 These fiords shall be held by the institution for a period of three years. In the event that cc) Li t e UJ U R- VA, (responsible aforementioned requirements, Mason Countymaynemsa name)does not comply.with the make,payment to Mason County of said funds hat the necess he institution shall Performed immediately to Mason County standards. The institution shall of beairs can l able t ute _ v2 M (responsible ° said funds to Mason County. The conditions in this agreementfmay on�y be amended o revoked by express written co r condition of Mason County. Signature of Responsible Party y S Date Confidential Page 1 Form Revised:03/25/03 r� JLe—ckk 'Accepted: Name of Bank/Phone Number KApproved: Title: Bank Address Date Account Number STATE OF WASHINGTON, County oft (Individual Acknowledgement) I, Notary Public in and for the State of Washington,residing at do hereby certify that on this 0" day of Sec3� Y� , 20 0 personally appeared before me , to me known to be the individual described herein and who executed this instrument and acknowledged that signed and sealed the same as c U free and voluntary act and deed for the uses and purposes herein mentioned. GIVEN UNDER MY HAND AND OFFICIAL SEAL this_��}' day of 20�C?_. WAN Q�- Notary Public in an for the State of `\�..,� �t, Washin .off'residing at ,z-"' fAAR/F� �it ( in said ''j��i, County. My Commission expires i lo,�OF�W AS�� Confidential Page 2 Form Revised: 03/25/03