CITY OF LACONIA

REQUEST FOR RELEASE/DRAWDOWN OF SITE SECURITY

TO: Planning Department DATE: ___________________

FROM: ______________________________________ APPL. # ___________

PROJECT ADDRESS & NAME: ____________________________________________

I request the release of the site security amounts listed below:

DESCRIPTION	% WORK COMPLETED	AMOUNT REQUESTED BACK
1. Drainage
2. Roadway
3. Sewer
4. Landscaping
5. Sidewalk/Curbing
6. Lighting
7. Stabilization
8. Site Restoration Security
9. Fire Prevention Items
10. Misc. (List)
TOTAL RELEASE AMOUNT REQUESTED:
Less Landscaping Security (if applicable)
TOTAL ADJUSTED RELEASE AMOUNT:

I understand that my conditional Planning Board approval may stipulate that Landscaping Security be held for a specified period while other securities may be eligible for release.

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Requester - Pleased print name above

_________________ __________________________________

Date Signature of Requester

Reviewed By: _____________ Approved By: ___________________________

Comments: ________________________________________________________

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