HomeMy WebLinkAboutWPO201500033 Agreement - Nutrient Credits 2017-04-23DEPARTMENT OF ENVIRONMENTAL QUALITY
WATER QUALITY ENHANCEMENT FEE FORM
Instructions:
Nonpoint nutrient offset brokers are required to pay a water quality enhancement fee equal to six
percent of the amount paid by the permitted for the nonpoint nutrient offsets.
With submittal of this payment, brokers should complete this form and submit it with their
payment. Payment should be in the form of check or money order payable to "Treasurer of
Virginia" and should be mailed to:
Department of Environmental Quality
Receipts Control
P.O. Box 1104
Richmond, Virginia 23218
You should retain a copy for your records. Please direct any questions regarding this form or fee
payment to andrew.hammond@deq.virginia.gov.
Offset Broker:
Name: HSC- NOTB, LLC FIN: 20-0951328
Mailing Address: 31 Garrett Street
City: Warrenton State: VA Zip: 20186 Phone: 540-347-1000
Daytime Phone Number: 540-687-0171
Name and Location of Construction Activity:
Name: Hillbrook WPO-2015-00033 and WPO-2017-00029, Parcel ID 06100-00-01-126GO
Town, City, or County: Albemarle County
VSMP Permit Number:
Nutrient Bank:
Bank Name: Gold Hill Nutrient Offset Trading Bank
Bank James-014
Total Phosphorus Purchased:
1.02 Pounds
Amount of Fee Submitted
(6% of the amount paid for the nonpoint nutrient offsets): $ 734.40
FOR DEQ USE ONLY
Date: DC #:
(DEQ 199-210)(06/13)