HomeMy WebLinkAboutSUB202100179 Bond 2022-07-06Internal Use only
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Daft Received: Fee Paid:
Received by:
Intake: Forward to Program Administrator
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REQUEST TO ESTABLISH A BOND
APPROVED PLAN # Su 6 2b2i D019q
PROJECT NAME: (M10'Xi 0 .96AQ I� I1O ppP� WAitr LSewt r
(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: qhq OWNER'S
SIGNATURE: V--�
date: 6 124 2Z
TAX MAPS / PARCELS:
OWNER'S NAME:
SIGNATURE:
date:
TAX MAPS / PARCELS:
OWNER'S NAME:
SIGNATURE:
date:
TAX MAPS / PARCELS:
OWNER'S NAME:
_
SIGNATURE:
date:
TAX MAPS / 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; (Fees include 4% Technology Fee)
❑ VESCP Erosion & Sediment Control per Water Protection Ordinance section 17-207; $0 fee
❑ VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water
Protection Ordinance section 17-208; $294.32 fee required
Subdivision (roads, drainage, etc.) per Subdivision Ordinance section 14-435;
& Water & Sewer per Subdivision Ordinance section 14-435; $307.84 fee required
A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please provide
contact information.
EMAIL:
OR REGULAR MAIL ADDRESS:
Revised 7/1121
0 Your Payment
Was Submitted
Transaction ID: 7KV142978R4081212
Transaction 06/28/2022 05:10
Time: PM
Total Paid: $316.04
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 $307.84
Item Number: E66252
Type: Community Development
Other
Notes: Galaxie Request to Establish
Bond SUB202100179
Transaction Fee $8.20
Total $316.04
AtIaS ATLAS Construction Management
455 2°d St SE Suite 201
e= Charlottesville, VA 22902
Document Transmittal
TO: FROM:
Ana Kilmer Tucker Loyd
COMPANY: DATE:
Albemarle County 6/29/22
TOTAL NO. OF PAGES INCLUDING COVER:
RE:
RE: Galaxie Farm - Request to Establish Bond
Hi Ana,
Please find attached request to establish bond for Galaxie Farm along with copy of the
receipt.
Sincerely
Tucker Loyd
ATLAS Construction Management
Tuckeratlas@gmail.com
434-249-9885