HomeMy WebLinkAboutWPO201700055 BondInternal V00%
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Date Received: R )61 x 2
Recrk,ed b%:
Intake: Forman 'Ma. agement AnalyNt M
, A)
REQUEST TO ESTABLISH A BONI) JJ
A PPROV 1`11) PLAN WP0201700055 #4 CC-, Pr AB
PROJECTNAME: Orchard Acres Water Main Replacement
(As listed on the approved plan)
All parcels in the project, including any off -site %vork if easements are not provided, and current owners. Use a
separate sheet if more owners are require(]. 0xvner and tax map information Must be correct. and plans must be
approved prior to bond estimates being prepared,
FAX MAPs i PARCE'l-s: 55C-OH-16 OWN"ER'S NAME: MANDY D SNOW
SIGNATURE: . . . ....... . . . ..... . — --- _-_ — ------- date:
_---
TAX %1,1APs 'PARCE'll-s: 55C-OH-15 OWNER'S NAME: SANDRA R CRANE/MARA KUZNAR
S I GIN ATU R I : . ...... . date:
, --
TAX MAPs "PARCELs: 55C-OH-14 OWN. NAME: ANTHONY OR REBECCA HUGHES
SlCiNATURE: date:
----
TAXMAPS /PARCELs: 55C-OH-13 OWNER'S NAME: JAMES OR AMANDA DAVIS
S I GN ATUIR E:
TAXMAPS /PARCF1.s: 55C-OH-12 OW'N"EKS NAME: MARTIN OR JUNE ANDREWS
S16NATURL (late:
—'Off o B , OD
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 Countv must be submitted certifvin2 that
the person signing above has the authority to do so.
The requested estimates are.
W VESCIP F'rosion & Sediment Control per Water Protection Ordinance section 17-207: $0 fee
F1 VSMP Erosion and Sediment Control, Stornixvater Management and Mitigation per Water
Protection Ordinance section 17-208. $250 fee required
L3 Subdivision (roads, drainage. etc.) per Subdivision Ordinance section 14-435.
& Water & Sewer per Subdivision Ordinance section 14-435: S269 fee required
A bond estimate will be prepared by the plan reviewer. The estirnate must be sent to the owner. Please provide
contact information.
EMAIL: TLntq_nI&w,rallp.con
OR REGULAR MAIL ADDRESS:
kevv,4�,d 6,20,2014, 1 13 'W �