HomeMy WebLinkAboutWPO202000032 Other 2021-04-14Internal Use only �1 A
Date Received: Pee Paid: aL So 0VOF L1�Fn
Received by: V'T� y
Intake: Froward to Management Analyst 114
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REQUEST TO ESTABLISH A BOND
APPROVED PLAN # WP020200032
PROJECT NAME: 1300 Richmond Road
(As listed on the approved plan)
All parcels in the project, including any off -site work if easements 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.
TAX MAPS /PARCELs: 78-6 OWNER'S
SIGNATURE:
T'AX MAPS / PARCELs: 7&7 OWNER'S
TAX MAPS / PARCELs:
TAX MAPS / PARCELs:
TAX MAPS / PARCELs:
SIGNATURE:
OWNER'S NAME:
SIGNATURE:
OWNER'S NAME:
SIGNATURE:
OWNER'S NAME:
SIGNATURE:
date: y S'-z 1
date: I
date:
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 must 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; $0 fee
[A VSMP Erosion and Sediment Control, Stonnwater Management and Mitigation per Water
Protection Ordinance section 17-208; S250 fee required
O Subdivision (roads, drainage, etc.) per Subdivision Ordinance section 14-435;
& Water & Sewer per Subdivision Ordinance section 14-435; $269 fee required
A bond estimate will be.. prepared by the plan reviewer. The estimate must be sent to the owner. Please provide
contact informmgtje t '! /
EMAIL: b�a o w.s Z` (o ' 0 efOIM
OR REGULAR MAIL ApDR$SS:
Revised 6/2012014, 11132015
4/9/2021
Shimp Engineering, P.C. Mail - Payment Submitted
Gmail
Payment Submitted
1 message
Albemarle County - VA - Tax <no-reply@sturgiswebservices.com>
To: rachel@shimp-engineering.com
PAYMENT SUBMITTED!
Transaction ID 7YG88756B5555781U
Total Paid $256.72
Rachel Moon <rachel@shimp-engineering.com>
Fri, Apr 9, 2021 at 3:42 PM
Item
Amount
Item Number: 826688
$250.00
Type: Community
Development WPONSMP
Notes: WPO2020-32 1300
Richmond Road request to
establish bond
Transaction Fee
$6.72
Total
$256.72
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