BLD-05-0342
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-05-0342- YL
Issue Date. 10/12/2005
(Work must be started within 180 days)
Receipt No
38533
Name. Baker, Manace E
Phone:
253-261-0572
Address: 390 4th Ave SE
City' Pacific
State. WA Zip 98047
~~9pertyltlJoHna!ion:
Site Address: 10428 Grove Road
Assessor Parcel No. 64303100703
Subdivision: N/A
Lot: C
Name: American Dream Construction
Contact:
Phone: 360-882-3218
Address: 390 4TH Ave SE
City' Pacific
State: WA Zip. 98047
Contractor License No' AMERIDC004BL
Expires: 01/15/0515
Business License:
Proje~~llnform:~tion:
Project: Mannace E Baker
Description of Work: 176 sq. ft. Carport added to permit 04-0092
Permit overpaid by 320.05. To be credited to
05-270, 05-349 & 05-0409
Sq. Ft. per floor' (1 st) 0 (2nd) 256 (3rd) 0
Heat Type (Electric, Gas, Other). GAS
Garage 0
Basement 0
Item Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
--------------------------- -------------
Building Permit - Other 27580 0.00 000 o 0000 o 0000 $1,000
Building Plan Review 179.27 0.00 000 o 0000 o 0000
State Building Fee 450 450 000 0.0000 o 0000
TOTAL FEES. $459.57
Applican!~iAffadav,~;~:~
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition all covenants,
easements and restrictioJ1s of rec~rd. If applying as a contractor, I futher certify that I am currently
registered in the ~~~~~?~hin9ton.
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Firm
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Permit No
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
BLD-05-0342- YL
Issue Date. 10/12/2005
(Work must be started within 180 days)
~pplicant's Affadavit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the St t:Of Washington. ~"'I
Signature ~~ ~ Date ,~ 0,
Firm
Receipt No
AJ)plicant:
Name: Baker, Manace E
Address: 390 4th Ave SE
City' Pacific
Property Information:
Site Address. 10428 Grove Road
Assessor Parcel No. 64303100703
Subdivision: N/A
Contractor Information:
Name: American Dream Construction
Contact:
Address. 390 4TH Ave SE
City' Pacific
Contractor License No' AMERIDC004BL
Expires. 01/15/0515
Project Information:
Project: Mannace E Baker
Description of Work: 256 sq. ft. added to perm it 04-0092
Sq. Ft. per floor (1st) 0
(2nd) 256
(3rd) 0
Garage 0
Heat Type (Electric, Gas, Other) GAS
Fees.
Item
Item Fee Base Amt
Unit Fee
Unit Rate
Building Permit - Other
Building Plan Review
State Building Fee
TOTAL FEES.
275.80
179.27
450
$459.57
0.00
0.00
450
000
0.00
0.00
0.0000
o 0000
o 0000
38533
Phone:
253-261-0572
State: WA Zip 98047
Lot: C
Phone: 360-882-3218
State: WA Zip: 98047
Business License:
Basement 0
No. Units Unit Desc
00000 $1,000
o 0000
o 0000
OFFICIAL USE ONLY
# Sets of Prints.
Final Inspection:
~
<l
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit Fees Schedule
Permit No BLD-05-0342-YL
Applicant:
Name. Baker, Manace E
Phone.
253-261-0572
Address. 390 4th Ave SE
City' Pacific
State. WA Zip 98047
Project Information:
Project: Mannace E Baker
Description of Work: 256 sq. ft. added to permit 04-0092
Site Address 10428 Grove Road
Assessor Parcel No. 64303100703
Fees.
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
---..----------------------- -------------- -----------
Building Permit - Other 032 001-322-10-00 275.80 000 000 o 0000 o 0000 $1 000
Building Plan Review 100 001-345-83-00 179.27 000 000 o 0000 o 0000
State Building Fee 160 001-386-00-00 450 450 000 o 0000 o 0000
TOTAL FEES $459.57
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RECEIPT No 3 8 5 3 3
F ECEIVED
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RECEIVED FROM
DATE
REC NO
AMOUNT
REF NO
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CI1'( Of '(E\..\III- eUI\..OING OEP ARi\lllENi
RESIOENiIA\.. CERilflCA iE Of oCCUP ANC'(
Bui\din9 permit Number
~
~ction
3901\ p..\le. SE.
~OA7
~
p\an Number
Bui\din9 p..ddress
Owner Name
owner p..ddress
~
RemarKS.
--
p.,.,\\ code reQuired
f\UOUS\262005
p..reas \ns~ected
s~ecia\ conditions
None
o ate
~
. . Intemotiono\ ResidentiOI Code (CnoVter
1niS structure is in comvllonce ~~~~~: ton stote Building code Council Vursuont
5~-5~ Wp..C) as ado~ted b'l t"'7ea. d 70 ~2 RCW eHective jU\'l ~ \ 2004
\0 c",a~ters ~ 9.2 an '
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CITY OF YELM INSPECTION LOG
PROJECT ;54'- J~e--~ - U ,I-~
PERMIT NUMl3ER CJL.{ - OC)~
ADDRESS
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.
~-ru ~ t2d.. St?
SET BACKS
Front
Rear
SIde/Flankmg
SIde
Date {CilLq ~8JQ 1-1
( I
FOOTING
12"
~
~
reqUIred vents
~ate.tf/jJ'!J WALL REBAR V
WALL
6"
8"
other
FOOTING REBAR
Date q /2fff
I
Comments
~
G
COMBIl\TED FRAlVIE/ EXTERIOR SHEAR WALL INSPECTION
Hold downs Shear Nmlmg ok ~J:I...
Frame Gas/Propane
Plumbmg Mecharncal
Comments U f ~ ~/Jl O(
3-/7, oJ-
INSULATION
Gas
Foam and Seal
Electnc
Yapor barner
other
PYA
Comments
SHEET ROCK/SHEAR WALL NAIL
Comments
OTHER
Comments
c
FIN AL
Se~~inal
A~
comments-f);..A-~~
EI~
Ins uJ;rt'i on
~~~~ J/b'b~
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end Fmal
SIte Dramage
Landscape F mal
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City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit No
BLD-04-0092-YL
Issue Date 09/21/2004
(Work must be started within 180 days)
Receipt No
33208
Applicant:
Name Baker, Manace E
Phone
253-833-3487
Address 390 4th Ave SE
City' Pacific
State WA Zip 98047
Prop~rty)l1f9rr:ratio.l1..:.
Site Address. 10428 Grove Road
Assessor Parcel No 64303100703
Subdivision. N/A
Lot: C
Contractor Information
Name American Dream Construction
Contact:
Phone 360-882-3218
Address 390 4th Ave SE
City' Pacific
State: WA Zip
Contractor License No AMERIDC004BL
Expires. 01/15/0415
Business License:
pr,oJect Information
Project: Mannace E Baker
Description of Work: 2240 SFR
Sq. Ft. per floor' (1 st) 1344 (2nd) 1344 (3rd) 0 Garage 0 Basement 0
Heat Type (Electric, Gas, Other) GAS
Fees.
Item Item Fee Sase Amt Unit Fee Unit Rate No Units Unit Desc
--------------------------- -------------
Building Permit 100-500k 1,252.64 993 75 258.89 5 6000 46.2300 $1 000
Building Plan Review 529.24 0.00 000 o 0000 o 0000
Mechanical Permit 159 50 000 000 o 0000 o 0000
Plumbing Permit 1 04 00 2000 8400 7 0000 12.0000 Fixture
Water ERU 1,50000 000 1,500 00 1,5000000 1 0000 ERU
Water Meter (SFD) 300 00 300 00 0.00 o 0000 o 0000
Water Deposit 4000 4000 000 o 0000 o 0000
State Building Fee 450 450 000 o 0000 o 0000
TOTAL FEES $3,889.88
Ap pi ica nt's Affa.d-avit:
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in conformity with all applicable City of
Yelm regulations including those governing zoning and land subdivision, and in addition, all covenants,
easements and restrictions of record. If applying as a contractor, I futher certify that I am currently
registered in the St te Washington.
OFFICIAL l:JSE ONLY
# Sets of Prints.
Date
'1- Z./. O'i
Signature
Firm
o
o
City of Yelm
Community Development Department
Building Division
Phone: (360) 458-8407
Fax: (360) 458-3144
Permit Fees Schedule
Permit No BLD-04-0092-YL
Applicant:
Name. Baker, Manace E
Phone'
253-833-3487
Address 390 4th Ave SE
City' Pacific
State: WA Zip 98047
Project Inforin~tiol1
Project: Mannace E Baker
Description of Work: 2240 SFR
Site Address. 10428 Grove Road
Assessor Parcel No 64303100703
Item Acct Code Item Fee Base Amt Unit Fee Unit Rate No Units Unit Desc
--------------------------- -------------- -------------
Building Permit 100-500k 032001-322-10-00 1,252.64 993 75 258 89 5 6000 46.2300 $1,000
Building Plan Review 100 001-345-83-00 529.24 000 000 o 0000 o 0000
Mechanical Permit 032 001-322-10-00 159 50 000 000 o 0000 o 0000
Plumbing Permit 032 001-322-10-00 104 00 2000 8400 7 0000 12.0000 Fixture
Water ERU 712 401-343-80-01 1,50000 000 1,500 00 1,500.0000 1 0000 ERU
Water Meter (SFD) 712 401-343-80-01 300 00 300.00 000 o 0000 o 0000
Water Deposit 740402-389-00-00 4000 4000 000 0.0000 o 0000
State Building Fee 160 001-386-00-00 450 450 000 o 0000 o 0000
TOTAL FEES $3,889.88
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Property Tax #.
Site Address
City'
Subdivision
Sub Type
Work Proposed
Permit Description
Thurston County Public Health & Social Services
On Site Sewage Systems Permit # 03-106616-000
64303100703
Lot#"
/";)
I
l
Plans Approved By"
Issued Date 05/13/04
Issued By' Vince McDowell
Expire Date 05/13/07
UNKNOWN
On Site Sewage System
New. City
3 bed csa
Applicant:
Address
Owner.
Address
OSS Designer'
Address
MANNACE E BAKER
386 4TH AVE SE PACIFIC, WA 98047
MANNACE E BAKER
386 4TH AVE SE PACIFIC, WA 98047
Paul Morneau/Alternative Designs
Po Box 1962 Yelm, WA 98597 / 343
Phone (360)458-9548
Info
Proposed Sewage System Use Residential, S Number of Bedrooms
This OSS system is experimental
Disinfection
No Tank
None Transport
3 Water Supply Type
Concrete Pre/treatment
Group A
None
Pressure distribution Disposal
Trench sand-lined (C33)
OSS serves a food establishment
No An Operation . Maint Cert is required No
Access Issues.
Directions.
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE LOCATIONS AND
RELATED EASEMENTS.
Installation must be in conformance with the stamped, approved design for this permit number This permit may
be revoked if the site conditions have changed since the design was approved
The on-stie sewage system may be installed only by an installer certified in Thurston County or by the resident
owner of the property A resident owner installer must contact the Environmental Health reviewer prior to construction
Depending on the specific situation the resident owner installation may be subject to multiple inspections.
This system may not be used until the final As-built drawing is accepted by this department.
For FINAL INSPECTION. call 360-786-5400
Page 1 of 1
~'-~~~~~~~W~~~:T~1.~~~~\JiLi!1!3'l:"~~.1.'Ji~81~W~~~~~~""i;'~;""'.'''';;;rd.c'.'.!;~+~,~-'1
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,r ~ elm 'J'J,..., +J')~/
I ~~:~ 3f30158-&403
I
I RECE!VE.P* * *THREE THOUSAND EIGHT HUNDRED EIGHTY NINE DOLLARS & 88 CENTS
I
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RECEIPT No
RECEIVED FROM
DATt::
REC NO
AMOUNT
NAMACE E. BAKER
390 4TH AVE SE
PACIFIC. WA 98047
09/21/04
33208
3.889.88 CHECK
2767
SITE: 10428 GROVE RD
MISCELLANEOUS RECEIPT
DIANA
BLDPRMT 1252.64. PLNREV529.24. MECHPRMT159.50. PLMB PRMT104. .W/ERU1500.00
W/MTR300. W/DEP40.. STATEFEE4.50
PO 80x 47q
relm WA, 98597
360-4:58-8403
RECEIPT No 33209
RECEIVEn
-***FOUR THOUSAND ONE HUNDRED SEVENTY FOUR DOLLARS & 85 CENTS
RECEIVED FROM
DATE REC NO
09/21/04 33209
AMOUNT
REF NO
MANACE E. BAKER
4.174.85 CHECK
2767
*************** -COMM. JOU~- ******************* DATE FEB-\:)2003 ***** TIME 05:57 ********
MODE =
MEMORY TRANSMISSION
START=FEB-25 05:55
END=FEB-25 05:57
FILE NO.=180
STN
No.
COMM.
KEY NAME
STATION NAME/EMAIL ADDRESS/TELEPHONE NO. PAGES
DURATION
001
OK
a
912538334414 002/002
00:00:43
-Yelm CDD
***** DP-3520 ********************** -Yelm CDD
- ***** -
360 458 3144- *********
City of Yelm
Community Development Department
Building Division
Phone: (360)458-8407
~1, ~d
Jt0 " 4
Permit Fees Schedule
Permit No: BLD-04-0143-YL
Fax: (360) 458-3144
Appllcan~,
.,-
,
Name: Baker Manace E
Phone: 253-261.0572
Address; 390 4th Ave SE
City' Pacific
Stale: W A Zip 98047
PrQJect',jrifolmatlo~:
Project: Mann8ce E Baker
Description of Work; 2240 SFR
Site Address; 10440 Q.ove Road
A.sessor Parcel No. 64303100704
Feeg; ,. ,.
..J:,
IIem Aeel Code Item Fee Base AmI Unil Fee Unit Rate No. Units Unit Desc
a____~_
Building Permit 100-500k 032 001.322-10-00 1.252.64 993.75 258.89 5.5000 46.2300 $1.000
Building I"lon Review 100001-345-83-00 529.24 0.00 0.00 0.0000 0.0000
Meohanlcall"ermil 032001.322.10.00 159.50 0.00 0.00 0.0000 0.0000
Plumbing Permit 032001-322-10-00 104.00 20.00 64.00 7.0000 12.0000 Fl>lul'8
Warer ERU 712 401.343.80.01 1.500.00 0.00 1,500.00 1.500.0000 1.0000 ERU
Waler Meter (SFD) 712401-343-60-ot 300.00 300.00 0.00 0.0000 0.0000
Wale' Depostt 740402.369.00-00 40.00 40.00 0.00 0.0000 0.0000
Stale Building Fee 160001-300-00.00 4.50 4.50 0.00 0.0000 0.0000
TOTAL FEES: $3,889.88
"
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CoPy
o
Property Tax #"
Site Address
City'
Subdivision
Sub Type
Work Proposed
Permit Description
Thurston County Public Health & Social Services
On Site Sewage Systems Permit # 03-106616-000
64303100703
Lot#.
C;7
~
Plans Approved By'
Issued Date 05/13/04
Issued By' Vince McDowell
Expire Date 05/13/07
UNKNOWN
On Site Sewage System
New. City
3 bed csa
Applicant:
Address
Owner'
Address
OSS Designer"
Address.
MANNACE E BAKER
386 4TH AVE SE PACIFIC, WA 98047
MANNACE E BAKER
386 4TH AVE SE PACIFIC, WA 98047
Paul Morneau/Alternative Designs
Po Box 1962 Yelm, WA 98597 / 343
Phone (360) 458-9548
Info
Proposed Sewage System Use Residential, S Number of Bedrooms
This OSS system is experimental No Tank:
3 Water Supply Type
Concrete Pre/treatment
Group A
None
Disinfection
OSS serves a food establishment
None Transport Pressure distribution Disposal
No An Operation & Maint Cert is required No
Trench sand-lined (C33)
Access Issues.
Directions:
PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING AND MARKING ALL PROPERTY LINE LOCATIONS AND
RELATED EASEMENTS.
Installation must be in conformance with the stamped, approved design for this permit number This permit may
be revoked if the site conditions have changed since the design was approved.
The on-stie sewage system may be installed only by an installer certified in Thurston County or by the resident
owner of the property A resident owner installer must contact the Environmental Health reviewer prior to construction.
Depending on the specific situation the resident owner installation may be subject to multiple inspections.
This system may not be used until the final As-built drawing is accepted by this department.
For FINAL INSPECTION. call 360-786-5400
Page 1 of 1
o
L~4 11 C
o
COUNTY COMMISSIONERS
Cathy Wolfe
District One
Diane Oberquell
District Two
Robert N Macleod
District Three
THURSTON COUNTY
September 15, 2003
\ DL\ 2 $3
'I c \ IIV\
PUBLIC HEALTH AND
SOCIAL SERVICES DEPARTMENT
&/OV~ ~J
q~54l
Sherri McDonald, RN, MP A
Director
Diana T Y u, MD, MSPH
Health Officer
1II.\".~"lIiI: 1IiI_~_tIJl!M _'l'IllI~1liiiI
SINCE 1852
Manny Baker
386 4th Ave SE
PaCific, Wa 98047
Subject., On-Site Sewage Permit Application # 03 106616, Parcel 64303100703
Dear Mr Baker'
On August 27,2003, you applied for a permit for an On-Site Sewage System (aSS) for the
above referenced parcel That application is now approvable In order for this agency to
release the permit to Install the ass, all outstanding fees must be paid Enclosed IS the
invoice showing all fees due to EnVironmental Health
You may pay the fees In person at the Permit Assistance Center, Thurston County
Courthouse, Building 1, and obtain the permit at that time, or you may mai: the fees to the
following address, and we Will mall the permit to you
Please include the permit number and parcel number on your remittance, and mail
to:
Thurston County EnVironmental Health Department
2000 Lakeridge Dr SW
Olympia WA 98502
Attn On-Site Support Staff
Please request that your deSigner submIt the final"Asbuilt" drawing as soon as pOSSible
after ass installation occurs
If you have questions, please feel free to call our office at (360) 754-3355, ext 6518
SinCerelY,. ' A j
W~JJU4
Wendy O'Donnell Mathews
EnVironmental Health Program ASSistant
Environmental Health Division. 2000 Lakeridge Drive SW, Olympia, Washington 98502-6045
Fax (360) 754-4462 · TDD (360) 754-2933
www.co.thurston.wa.us/health
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Project Address
Subdivision:
CITY OF YELM
RESIDENTIAL BUILDING PERMIT APPLICATION FORM
lOY z-<z (fRO V F fd SE Parcel #. ((}43031007D1.
Lot #. C /"{ Zoning,
~ew Construction 0 Re-Model/ Re-Roof / Addition 0 Home Occupation Sign
o Plumbing 0 Mechanical 0 Mobile / Manufactured Home Placement 0 Other
Project Description/Scope of Work:_f\Jew _~ F ~:5; ~VJ a:....
Project value.--.td () VVle 12.. 0 '( L A {\ l Co 0 K
L.. ; vc-A6L.. f:-
Building Area (sq ft) 1st Floor Is Y ~ 2nd Floor <ZCf Co Garage Deck
Basement Carport Patio
# Bedroo~s '3 # Bathrooms :J. 5 Heating' GAS/OTHER ~Circle One)
Are there any environmentally sensitive areas located on the parcel? If yes, a
completed environmental checklist must accompany permit application.
SUIL.DING,'bWNEBNAME. fv' A
AobRESS.'2QO'" l,.--j1S }1V{ c".E-
CITY PA/..\.hL STATE UJA ZIP Q8'041 TELEPHONE Z?
ARg!8ITEGILgN.GI~~E8 :;A INti:.
ADDRESS
CITY STATE ZIP
LICENSE #
TELEPHONE
GENERALC:;ONTRACT"()R t:.-\lM;:(I(;AVI ()(~4w\ [pAL.TELEPHONE
AbDRES~qo . Cj1}j Ave 5e
CITY i)A(t~\( STATE IfJ,A ZIP 1901..jl FAX z.-5:5 (/?'3-l.--/Yf'j
CONTRACTOR'S LICENSE # AIl-lee.IOCtPl/~ELEXP DATE 05CITY LICENSE #
PJ_UMBING'CONTRACTOR
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
TELEPHONE
ZIP
FAX
EXP DATE CITY LICENSE #
MECHANICAL CONTRACTOR
ADDRESS
CITY STATE
CONTRACTOR'S LICENSE #
TELEPHONE
ZIP
FAX
EXP DATE CITY LICENSE #
Copy of mitigation agreement with Yelm Community Schools, if applicable
I hereby certify that the above information is correct and thaHhe construction on, and the occupancy and the use
of the above described property wi! be in accordance with the laws, rules and regulations of the State of
W"h;n~~ th, CI~
~~~~ ~-+O~
Applicant's Signature Date
Owner / Contractor / Owner's Agent / Contractor's Agent (Please circle one)
All permits are non-transferable and will expire if work authorized by such permit is not
begun within 180 days of issuance, or if work is suspended or abandoned for a period of
180 days
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General/Specialty Contractor
A business registered as a construction contractor with Uti to perform construction work within the scope
of its specialty A General or Specialty construction Contractor must maintain a surety bond or assignment
of account and carry general liability insurance
License Information
License AMERIDC004BL
Licensee Name AMERICAN DREAM CONCEPTS
Licensee Type CONSTRUCTION CONTRACTOR
UBI 601205792 Verify Contractor Premium Status
Ind Ins Account Id 82981500
Business Type INDIVIDUAL
Address 1 390 4TH AVE SE
Address 2
City PACIFIC
County KING
State WA
Zip 98047
Phone 2538333487
Status ACTIVE
Specialty 1 GENERAL
! Specialty 2 UNUSED
Effective Date 1/13/2000
Expiration Date 1/1512005
Suspend Date
Separation Date
Parent Company
Previous License MANNAC*088KR
Next License
Associated License
Business Owner Information
Name
Role
OWNER
Effective Date
01/1312000
,~-~'^^^
BAKER, MANNACE E IV
https.//fortress wa.gov /lm/bbIp/ detaIl aspx?LIcense= AMERIDC004 BL
7/2/2004
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B d 1ft'
on norma Ion
Bond Bond
Company Account Effective Expiration Cancel Impaired Bond Received
Bond Name Number Date Date Date Date Amount Date
ACCREDITED
SURETY &
#3 CAS CO INC 8329 09/13/2002 $12,000 00 09/09/2002
INDEMNITY
INS CO OF N
#2 AMERICA CWACG61272 11/05/2001 10/08/2002 $12,00000 11/05/2001
INDEMNITY
INS CO OF N
#1 AMERICA IWACG61272 09/13/1999 11/05/2001 $6,000 00
.....".w..... ........... .......... .... .
Savings Information
No Matching Information
Insurance Information
Company Policy Effective Expiration Cancel Impaired Received
Insurance Name Number Date Date Date Date Amount Date
AMERICAN
STATES
#4 INS CO 01CE73014950 01/12/2004 01/12/2005 $1,000,000 00 12/02/2003
AMERICAN
STATES
#3 INS CO 01CE73014920 01/12/2002 01/12/2004 $300,000 00 12/23/2002
AMERICAN
STATES
#2 INS CO 01CE7301492 01/12/2001 01/12/2002 01/11/2001
AMERICAN
STATES
#1 INS CO 01 CE7301491 01/12/2000 01/12/2001
... .....w...... ..~..
Unsatisfied Summons/Complaints Information
No Matching Information
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