HomeMy WebLinkAboutWPO202100034 Preconstruction Form 2022-05-26n��'
Request for Pre -construction Meeting and Grading Permit yE
from Albemarle County — VSMP % :»,4`
Approved Plan Number: WPO- 201100OW DEQ Permit # (if applicable): VAR10-
Approved Plan Name: Vi c%e✓ i aN Neiok+s VW P Plow WP p —2.0 U 000 3 y
(Plans must be approved prior to a pre -construction meeting.)
Bond approved date: F 2,0� ZZ
(Bonds must be approved and posted prior to a pre -construction meeting or permit.)
Responsible Land Disturber:
Print Name: MOIMeG'Iup, Ea tkwarlks L.LC
State RLD Number: RLD - N7157 5eo44 Kise✓
Address: 1900 Plemsaoh 1 rive
City: Harrisor►6urw State: A Zip: ILPOI
Daytime Phone: (N0) 7116 — 84 7-6 E-mail: flora( 0 moptat+"W1M✓'11 "ko - COY"
Primary Contractor:
Print Name: 5awe CAS a6oyt
Address:
City:
Daytime Phone: L_)
E-mail:
Permit Issuance Fees (Request must include payment) (Code §17-7081:
State:
Total acres proposed to be disturbed as shown on the approved plan and application:
Zip:
Acres
Acres to be Disturbed
Total Fee Due for Grading Permit
Total Fee — (Application Fee + 4"/o Technology Surcharge)
Less than 1
$74.88
$72 + $2.88
Single -Family Dwelling only —
$74.88
less than 5
($72 + $2.88)
1 and less than 5 acres
$700.96
1$674 + $26.96
5 and less than 10 acres
$881.92
3
, aG $848 + $33.92)
10 and less than 50 acres
$1,167.92
$1 123 + $44.92
50 and less than 100 acres
$1,581.84
($1,521 + $60.84)
100 acres and more
$2,490.80
($2 395 + $95.80)
Annual maintenance fees are assessed in arrears on April 1 each year or portion of a year that this permit is active
[Code §17-208].
7/l/14. Revised: 8/29/14. 10/18/18. 7/l/2021. 7/26/2021. 9/15/2021 Page 1 of3
Person(s) attending the Pre -construction Meeting:
Names (type or print) Firm Contact Number or email
_Toe SiWecopt Rivrx6ew$ q3q-ggi-163V
Keµ+ Hoa ry R Vt✓6¢ud ti;Y - 3Z6-Wgf
NGlNS Ha ;&0i4 AoutFvLh *, Ew4kwovkr 5yo-7Y6-p8L6
Alie-L Hakit River6"d- Y3Y-a6O-IY56
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/l/14. Revised: R/29/14.10/1R/18.7/l/2021.7/26/2021.9115/2021 Paee2of3
0 Your Payment
Was Submitted
Transaction ID: 5565451632096930E
Transaction 05/25/2022 01:08
Time: PM
Total Paid: $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.
Item Amount
Website Payment $594.00
Item Number: A57D8A
Type: Community Development
Other
Notes: Victorian Heights
WPOZO2100034 Pre -Construction
Transaction Fee $15.54
Total $609.54
0 Your Payment
Was Submitted
Transaction ID: 9DO76962PF794542H
Transaction 05/26/2022 09:57
Time: AM
Total Paid: $295.61
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.
Item Amount
Website Payment $287.92
Item Number: 795353
Type: Community Development
Other
Notes: Victorian Heights Pre -Con
request WPO-2021-00034
Transaction Fee $7.69
Total $295.61
User:
webpage
Payment Type:
CREDITCARD
Transaction Type:
SALE
Transaction ID:
260522EC0-2B5EF9AC-A293-4543-8FB7-1A5E34D038FC
Date / Time:
05/26/2022 09:50:18 AM
Response:
AA
Message:
APPROVAL
Approval Code:
026289
AVS Response:
Z
ECI:
CVV2 Response:
M
Partner App Id:
01
Account Balance:
0.00
Transaction Reference Number: 526135018
Account Data: ************1376
Expiration Date(MMYY): ****
Amount: 971.04
Tran Code:
SKU Number:
DEQ Permit ID: 628000217669
DEQ Permit No: VAR10R174
Company: Riverbend
Credit Card Holder's Name: Ashley Davies
Addressl:
455 Second Street SE Suite 201
Address2:
City:
Charlottesville
State/Province:
VA
Postal Code:
22902
Phone:
4342499885
Email Address:
Tucker.loyd@riverbenddev.com
Continue Shopping
From: DEPT OF ENVIRONMENTAL QUALITY noreply@elavon.com
Subject: Order Confirmation
Date: May 26, 2022 at 9:50 AM
To: Tuckerloyd@riverbenddev.com
DEPT OF ENVIRONMENTAL QUALITY
629 E MAIN ST
RICHMOND, VA 23219
804-698-4166
Order Results
Profile Name:
DEPT OF ENVIRONMENTAL QUALITY
Transaction ID:
260522EC0-2B5EF9AC-A293-4543-BFB7-1A5E34D038FC
Date/Time:
05/26/2022 09:50:18 AM
Transaction Type:
SALE
Approval Message:
APPROVAL
Approval Code:
026289
ECI:
Order Section
Card Number: ***** ....1376
Amount: $971.04USD
Billing Address
Company:
Credit Card Holder's Name
Addressl
City :
State/Province:
Postal Code:
Phone:
Email Address:
Riverbend
Ashley Davies
455 Second Street SE Suite 201
Charlottesville
VA
22902
4342499885
Tucker.I oyd@riverbenddev.com
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