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1 <br /> -. City of Santa . in °�O15 <br /> :Y7`' Clerk of the Count_�. <br /> AGREEMENT TERMINATION FORM <br /> COTC Office Use Only <br /> Please complete this form when the attached agreement and all 7015 Alri 3 P :tRa 7. 57 <br /> amendments (if any) are no longer in effect. <br /> Return form to the Clerk of the Council Office (M-30). CITY OF r <br /> Call 647-6520 if you have any questions. c ' " " <br /> The agreement with tk iN ar ,1 cir'i"444"- ) <br /> No. f /ow- 34 Lot <br /> as completed on Wes( \1.11G and final payment has been made. <br /> p2 (List all amendments. Use space below if needed.) '�` ` �p <br /> 4 A . 20111 -11 2- I q� Department: N q \� A. <br /> ttiii . <br /> # A - 2ol`4 - ZVI 00 <br /> Phone/Ext.: A <br /> Signature: <br /> Date: O& ZL — ` c <br /> Revised 08-23-10 <br />