HomeMy WebLinkAboutWPO201700011 Preconstruction Form 2018-03-01 If) . Ai ls
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Request for Pre-construction Meeting and Grading Permit ::.4fica
from Albemarle County *Avow,
Approved Plan61 T 0(S d
pp Number: WPO-PO-
Approved p p Plan Name: t€ k� : t o r \\
� �� �� S �4t 6,}SIC
(Plans must be approved prior to a pre-construction meeting)
Bond approved date: dr,96//v
(Bonds must be approved and posted prior to a pre-construction meeting or permit)
Responsible Land Disturber
Print Name: 0\-6 Gfr1-C kti( /
State Certification Number.
Address 15-00
City n -'0 . State 4/4 zip )o)-8'dl
Daytime Phone(SIP' ) '871)-.1/ t 1 . . .. E-mail (knQ : �'MoM eft 4-o M ect)►.. 'c,k Cd M
Primary Contractor
Print Name !"`6M-'l-40i -e-,l .tnld1-5
Address Il-06 �eaJo,
City (-)cry';J.,..S j State. lfo4 zip c3)84/
Daytime Phone(S`)) S '/- if Y6 E-mail t1cvt_S +et c./t Imo/k3 C a/L
Permit Issuance and First Year Maintenance Fees: (Request must include payment)
Total acres proposed to be disturbed is contained on the approved plan and application:
VSMP:
Acres to be disturbed Fee Due at Grading Permit.
Less than 1 $63.80
1 and less than 5 . $594.00
5 and less than 10 • • • $748.00
10 and less than 50 : . • $990.00
50 and less than 100 $1,342.00
100 and more $2,112.00
For plans exempt from VSMP,VESCP fees were paid with the application. .
7/1/
14,Revised:8/29/14 Page 1 of 3
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Person(s)to attend the Pre-construction Meeting:
Names(type or print) Firm Contact.Number or email
I ] -)c,f^'rn /14,1,^41�M
Acierrel 1<AS/ .Mann a AJA-► j �j�}
sAilr 4lin- v1��r�'�y � �'2�S-d O crf
_Ia4 ne_i 0" . A-lleA4w4 C v . . . {Jq'q y 9�s//. S/. y
eiyi n . By/ r_ l/� lain eqv .52- —2 3/.e -2 .3�
//cAP. 7 i,AL. 144 --v
VG-t,er ��3�
17
The second part of the application fee is required to be paid with this request This fee amount is;
FOR OFFICE USE ONLY Permit hoed Date
By who?
•
7/1/14,Revised:8/29/14 Page 2 of 3
•
'UNION BANK&.TRUST'' O33662
Southern Property, LLC cherIofteswue,VA 2291.1.
DBA Southern Development Homes es-316181a. . _
170 S Pantops Dr 02/22/2018
Charlottesville,VA 22911
PAY TO THE Albemarle County
ORDER OF•
**********63 DOLLARS AND'80.CENT$. _:..
DOLLARS_ I
Albemarle County
401 McIntire Road
Charlottesvil, VA 22902-4596
MEMO
NP
II'03366 2ll' 1:05 L403 L641: 51 2 1 203793v
THIS D_QCUMENT gONTAINB A COLORED BACKGROUND ON WHITE PAPER.MICROPRINT la LOCATED BELOW THIS WARNING BAND.
County of Albemarle 1131.68
Department of Community Development
PH: (434)296-5832 Date I
RECEIVED FROM:
Saitik"6_010r\ Q(( 4L1 U'LG pt,f ff Sou-wr)
AMOUNT: 5 )(
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+�j � GAL ll�.�� �- � w 3.
307 308 324 3 }$ 63, Z check 33[V.FLQ ?
For: cash
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Y�/`f 0 o UI ,
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