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HomeMy WebLinkAboutWPO201800028 Bond 2018-10-19 Internal Voe OnIt Date Received: Fee Paid: Received b,: '1 Dili Intake: Forward to Management Analyst rr tt REQUEST TO ESTABLISH A BOND APPROVED PLAN # W ? 0 2_0 Doc) 3� PROJECT NAME: ce U -A - - v i iv ct( (As listed on the approved plan) All parcels in the project, including any off-site work if easements are not provided,and current owners. Use a separate sheet if more owners are required. Owner and tax map information must be correct,and plans must be approved prior to bond estimates being prepared. OSSeb - GO - - TAX MAPs/PARCELs O -0t5O(,j OWNER'S N E: by'lei\ lAdLroIt4 L(, C SIGNATURE: ri'..&a date: to ( t ( l g TAX MAPs/PARCELs: OWNER'S NA SIGNATURE: date: TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date: TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date. TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date: NOTE: If ownership of the property is in the name of any type of legal entity or organization including, but not limited to the name of corporation,partnership,limited liability company, trust,association,etc.,documents acceptable to the County must be submitted certifying that the person signing above has the authority to do so. The requested estimates are: *VESCP Erosion& Sediment Control per Water Protection Ordinance section 17-207:$0 fee 0 VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water Protection Ordinance section 17-208:$250 fee required 0 Subdivision(roads,drainage,etc.)per Subdivision Ordinance section 14-435: Water& Sewer per Subdivision Ordinance section 14-435: $269 fee required A bond estimate will be prepared b) the plan reviewer. The estimate must he sent to the owner. Please pros ide contact information. EMAIL: -11 044 C SeJCVN G S -°`r .‘ V C�,c OR REGULAR MAIL ADDRESS: Rested h,211.20l4. 11 3'21/15