HomeMy WebLinkAboutWPO201500001 Preconstruction Form 2016-02-26 c..46 e2 0-6
Of
Request:for Pre-construction Meeting and Grading Permit
from Albemarle County $Ntiff,
Approved Plan Number: WPO- Q 13 ,OCCX)
'Approved Plan Name; OR-VinSTde (f) stimtifi Le
(Plans?ring be.approyed prior to a pre,constractlOnineeting)
Bond approved date; 1 1
Xe I301.6o
(Bonds must be approved and posted prior to a prg-catOti itctian meeting or permit)
Responsible Land.Disturber:
Priiit Narrie: •1-An•tdvh1'.1 _
State Certification Number 41;p:ts SD,
Address '1909 N.704.4).\-...sycJA
City C i ,v1p1-.-.‹ortte State. WA. .Zip
Daytime Phone(1713A). gqie--67q:i I EmaiI6/76;istf: {CArri,
Primary'Contratpor:
PiiiitName 6N2gt,61-zxe 6tei'T- 461
Address. I1tu74U1-41_
.city 14(6 0---4 State .Zip .
Daytime Phone,;(34) 9q6.- 6iet,-1- Qj rhxprerpat t, Cal()
•
:Perinit Issuance and First Year Maintenance Fees: (Req_iiest must include payment)
Total acres.proposed-0'1*diStuibed is Contained on:the approved Plait acid application
VSMP: •
Acres to be disturbed 'Fe DpeatQrading Permit
Less than 1 $63:80,
Land,leSs than 5 $594,00.
5 and less than 10 " $748.00 •
10 and less than,50 $990.001
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: 8129/14 'NO 1 6(3
Person(s):to attend the,Pre.;:opmtrnetion Meeting:,
Nameqtype'or print) Firm Contact Number or email
got( i- sib
6gftiut
.1131-CqG-59f I
11 I(
C—TLX4A44..,
The second prt bf the application fee is required to be paid with this request; 'Thistee qmpuht
yOR OFFICE Permit Issued Date .
7/1/14,Revised: 8/29/14 Page 2 of 3
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