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REQUEST TO ESTABLISH A BOND
APPROVED PLAN # SUB201900170____.____ — --
PROJECT NAME: Belvedere Phase 5A
(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.
I'AX MAPS / PARCELs; 62-160 __OWNER'S NAM. eW Belvedere Inc.
—date:4/28/2021SIGNATURE:_
TAX MAPS / PARCELS:
'FAX MAPS / PARCELS:
OWNER'S NAME:
SIGNATURE:
OWNER'S NAME:
SIGNATURE:
TAX MAPS / PARCELS: _ OWNER'S NAME:
SIGNATURE:
"FAX MAPS / PARCELS: _ OWNER'S NAME:
SIGNA'IURE:
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 certifving 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
❑ VSMP Erosion and Sediment Control. Stornwwater Management and Mitigation per Water
Protection Ordinance section 17-208; $250 fee required
V 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 estimate must be sent to the owner. Please provide
contact information.
EMAIL: skrohn@resortscompanies.com
OR REGULAR MAIL ADDRESS:
Re.6ed 612012014. 11/M2015
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