HomeMy WebLinkAboutWPO202000017 Preconstruction Form 2021-06-09Request for Pre -construction Meeting and Grading
Permit from Albemarle County -VSMP
Approved Plan Number:
Approved Plan Name:
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(Plans must be approved prior to a pre -construction meeting.)
(Bonds must be approved and posted prior to a pre -construction meeting or permit.)
Responsible Land Disturber:
.• IPrint Name: _ t �a (L J2-E 1 YT J�- l
State Certification Number:
Address 19 L l
city
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Daytime Phone �f '19 to ( 1 E-mail
Primary Contractor:
Print Name
Address
city
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Daytime PhoneOA) e1 lSc 11 E-mail
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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
563.80
1 and less than 5
5594.00
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
$2,1 l 2.00
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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.
7/1/14, Revised: 8/29/14, 8/28/199 8/25/2020 Page 1 of 3
Person(s) to attend the Pre -construction Meeting:
Names (type or print) Finn
Contact Number or email
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FOR OFFICE USE ONLY
W PO #
Fee Amount $ Date Paid By who? Rcccipt # Ck# By:
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7/1/14, Revised: 8/29/14, 8/28/19, 8/25/2020 Page 2 of 3
6/9/2021
Centralized Payments
0 Your Payment Was Submitted
Transaction ID:
Transaction Time:
Total Paid:
5XX03969YO477810Y
06/09/2021 11:06 AM
$609.54
We will receive notification of your online payment at the time that it is made and we will credit your payment as of that day.
However, you will not see the payment on your account for approximately 48-72 hours due to the time that it takes to get those
funds into our bank account.
a] Cancel Payment (http://www_albemarlecountytaxes.org/default.aspx?pagelD=110£tmp=Master. Master)
https:?/www.albemarlecountytaxes.org?payments/default.aspx