HomeMy WebLinkAboutWPO202100054 Preconstruction Form 2021-11-29Request for Pre -construction Meeting and Grading Permit
from Albemarle County — VSMP
Approved Plan Number: WPO-_Z0Z1-0OC6q DEQ Permit 0
Approved Plan Name: �GsSI t7/ ULAM
(Plans must be approved prior to a pre -construction meeting.)
Bond approved date:
(Bonds must be approved and posted
Responsible Land
Print Name:
to a pre -construction meeting or permit.)
VAR10-
State RLD Number:
Address: n4?-`-�-
City: C��SU 1 Ltd State: X&-- Zip:��
Daytime
Primary Contractor:
Print Name: �—LtcX �riD1i51 DI�
Address:
City: S
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�/�7'4id —O��T�V% r� State: �/� �/'4 Zip: LZ IU 2-.
Daytime Phone:M ZA "/ E-mail: eA- b-J j) nwog I ll�,1<CL7STl Gr{ l�
Permit Issuance Fees (Request must include payment) [Code §17-7081:
Total acres proposed to be disturbed as shown on the approved plan and application: Acres
Total Fee Due for Grading Permit
Acres to be Disturbed
Total Fee (Application Fee + 4% Technology surcharge)
Less than 1
$74.88
$72+$2.98
Single -Family Dwelling only -
$74.88
less than 5
($72+$2.88)
I and less than 5 acres
$700.96
$674+$26.96
5 and less than 10 acres
$881.92
$848+$33.92)
10 and less than 50 acres
$1,167.92
Sl 123+$44.92
50 and less than 100 acres
$1,581.84
$1,521 + $60.84)
100 acres and more
$2,490.80
$2,395 + $95.80
Annual maintenance fees are assessed in arrears on April 1 each year or portion of a year that this permit is active
[Code §17-2081.
7/1/14, Revised: 8/29/14, 10/18/18, 7/l/2021, 7/26/2021, 9/15/2021 Page l of3
Person(s) attending the Pre -construction Meeting:
The second par! of the application fee is required to be paid with this request. This fee amount is:
FOR OFFICE USE ONLY Permit Ivoea Date
By who?
7/1/14, Revised: 8/29/14, 10/18/18, 7/12021, 7262021, 9/152021 Page 2 of3