HomeMy WebLinkAboutWPO200500006 Preconstruction Form 2018-10-02 2/(g
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Request for Pre-construction Meeting and Grading Permit
from Albemarle County
Approved Plan Number: WPO-2005-000006
Approved Plan Name: Crutchfield Corperation Major Site Plan Amendment
(Plans must be approved prior to a pre-construction meeting.)
Bond approved date: October 2, 2018
(Bonds must be approved and posted prior to a pre-construction meeting or permit.)
Responsible Land Disturber:
Print Name: Delton Banton
State Certification Number RLD 07934
Address 295 Memory Lane.
City Troy State VA Zip 22974
Daytime Phone(434) 9773750 E-mail dj@agdillard.com
Pnmary Contractor:
Print Name AG Dillard Inc.
Address 295 Memory lane
City Troy State VA Zip 22974
Daytime Phone(434) 977-3750 E-mail josh@agdillard.com
Permit Issuance and First Year Maintenance Fees: (Request must include payment)
Total acres proposed to be disturbed is contained on the approved plan and application:
VSMP.
Acres to be disturbed Fee Due at Grading Permit
Less than 1 $63.80
1 and less than 5 $594.00
5 and less than 10 $748.00
10 and less than 50 $990.00
50 and less than 100 $1,342.00
100 and more $2,112.00
For plans exempt from VSMP,VESCP fees were paid with the application.
7/1/14,Revised: 8/29/14 Page 1 of 3
Person(s)to attend the Pre-construction Meeting:
Names(type or print) Firm Contact Number or email
DJ Banton AG Dillard Inc. DJ@Agdillard.com
John Alexander AG Dillard. Inc. John@Agdillard.com
ArQ..J Alhe/140 � ch4 - 91P'- S"l-5'
Doug Smy hers Crutchfield Corp. dsmythers@crutchfield.com
The second part of the application fee is required to be paid with this request. This fee amount is;
FOR OFFICE USE ONLY Permit Issued Date
By who?
7/1/14,Revised: 8/29/14 Page 2 of 3