HomeMy WebLinkAboutWPO202000014 Preconstruction Form 2020-10-15Request for Pre -construction Meeting and Grading it
Permit from Albemarle County -VSMP *:;
Approved Plan Number: WPO- -a O --)L OooC [ L4
Approved Plan Name: 9 \) O t\ rz� n 3 lA r lix\ �IGc r
(Plans must be approved prior to a pre -construct
meeting.)
(Bonds must be approved and posted prior to a pre -construction meeting or permit.)
Responsible Land Disturber:
Print Name: Brook Wood
State Certification Number: 15866
Address 1700 Cherry Ave
City Charlottesville
Daytime Phone(A34-g78-4435 E-mail brook@digsinc.com
Primary Contractor:
Print Name D van Z != • Sr, o w
State VA Zip 22903
Address 905 I pl G k 0 0tV
City ' t/ t I be State jf ` Zip N 1 CIO l
Daytime Phone ('(al_a t{ — Q g a -G E-mail di tAa t1 r% c L,�> W G1 m a i (• C 0 rr\
Permit Issuance and First Year Maintenance Fees (Request must include payment):
E
Total acres proposed to be disturbed is contained on the approved plan and
application: VSMP:
e disturbed
Fee Due at Grading Permit
1
$63.80
than 5
$594.00
than 10
M10$748.00
$748.00
s than 50
$990.00
s than 100
$1,342.00
ore
$2,112.00
Annual Maintenance Fees [Section 17-208 of the Albemarle County Code] — Annual maintenance fees will be assessed
in March of every year this permit is active. Fees cannot be prorated after the first year of permit issuance.
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Person(s) to attend the Pre -construction Meeting:
Names (type or print) Firm Contact Number or email
Brook Wood Digs Inc. 434-566-5401 / brook(d)digsinc com
FOR OFFICE USE ONLY
WPO#
Fee Amount $ _ Date Paid _By who? _ _ Receipt # Ck# _ _ _ By:
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