HomeMy WebLinkAboutWPO201800070 Bond 2018-09-21 Lj WLe///6
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REQUEST TO ESTABLISH A BOND
APPROVED PLAN#WP0201800070
PROJECT NAME: THACKSTON DRIVEWAY(OLD LYNCHBURG 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; 100-17A7 OWNER'S NAME: JOHN,ZHACKSTON
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SIGNATURE . __ - date: ig
TAX MAPs/PARCEL:s: OWNER' AME:
SIGNATURE: date:
TAX MAPS/PARCELs: OWNERS NAME: •_
SIGNATURE: date:
TAX MAPs/PARCELs: OWNER'S NAME:
SIGNATURE: date:
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TAX MAPs I PARCELs: OWNER'S NAME:
SIGNATURE: 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
0 VS1VIP Erosion and Sediment Control, Stormwater Management and Mitigation per Water
Protection Ordinance section 17.208; S250 fee required •
D 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 t-
contact information. ��pp �3
EMAIL: �� t/!/��fN//� Q �l ,._____—
OR R.E:GULAR.MAIL ADDRESS:
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