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HomeMy WebLinkAboutWPO201800001 Bond Estimates 2020-03-24Dne R 1 r&C' Fee Paid: Z S I.uke: F.—d t. Manage..., A..1r'.I I+RGIN"� APPROVED PLAN # PROJECT NAME: REQUEST TO ESTABLISH A BOND W PO 2018 00001 Rivanna Community Church - Santuary Addition (As listed on the approved plan) All parcels in the project, including any off -site work if casements 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. 03100-00-00-03200 Hood, Steve & Kathy ET ALS '; ru Tes Rivarma Community Church TAX MAPS /PARCELS: __OWNER'S N M ----OWNER'S _ _ __v date: J_��gq� .42-? TAX MAPS / PARCELs: OWNER'S NAME: SIGNATURE: date: TAX MAPS I 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 roust 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; SO fee �I VSMP Erosion and Sediment Control. Stormwater Management and Mitigation per Water Protection Ordinance section 17-208; $250 fee required ❑ 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 by the plan reviewer. The estimate must be sent to the owner. Please provide contact infonnation. EMAIL: RIVANNACHURCHCUOGMAIL.COM OR REGULAR MAIL ADDRESS: k,iscd 6420+2014. 11312015 County of Albemarle 121016 Department of Community Development �/1 a PH: (434) 296-5832 Date (4( RECEIVED FROM: ll ' l�A.y 41, ��©�L1 wA, ( AMOUNT: l %U ��✓� �%, Lit . „�� �' S �.7 G` 307 5 324 510 heck For: } cash credit card By RIVANNA COMMUNITY CHURCH 601 Earlysville Green Earlysville, VA 22,936 (434) 975-0011 PAY TO THE ORDER OF County of Albemarle Cm _ SUNUS ACHRTWI"I0 68-2/510 3/23/2020 $ "250.00 3320 Two Hundred Fifty and 00/100.........,.,— ................t............. ,............ DOLLARS County of Albemarle 8 401 McIntire Rd. Charlottesville, VA 22902 MEMO �6 AUTHORIZED SIGNATURE ) Request to Establish a Bond VV 11.0000 3 3 2011' t:0 5 i0000 201: 1000 10 20 L. 3 L 70111