HomeMy WebLinkAboutWPO201400055 Bond 2014-06-09 Request for Pre-construction Meeting and Grading Permit h "
from Albemarle County '"e'`
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Approved Plan Number: WPO- -2b 1 W — 060 SS'
Approved Plan Name: 11? Toe
e
(Plans must be approved prior to a pre-construction meeting.)
Bond approved date:
(Bonds must be approved and posted prior to a pre-construction meeting or permit.)
Responsible Land Disturber:
Print Name: G• �{�"� '0•00
State Certification Number: /363 17 003 b
Address 14 a o i v0.4 Dtg.5 f a .
City NAG/1 ur"`acA t.J Q State V4 • Zip 90210
Daytime Phone( I?g 53/s s i 8 E-mail iGti Li b eo4'1. 1 th.K. .
Primary Contractor: Q �/�
Print Name 1 CJ,JNI e..4 e •
Address t •V• ill i 7 Sd p
City O4 Avt-l s o State VG . Zip p•li°k
Daytime Phone(77) 57/— u S Vc ) E-mail
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 $63.80
1 and less than 5 $594.00
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 $2,112.00
For plans exempt from VSMP,VESCP fees were paid with the application.
7/1/14,Revised: 8/29/14 Page 1 of 3
Person(s)to attend the Pre-construction Meeting:
Names(type or print) Firm Contact Number or email
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?
7/1/14,Revised: 8/29/14 Page 2 of 3
Project Name: Tiptop Restaurant
WPO file number: WP0201400055
Erosion and Sediment Control Bond Estimate
Item Item
Number
stabluation (PS, TS)
silt fence (SF)
safety fence (SAF)
diversion (DD, FD, RW D)
temporary stape drain (TSD)
pipe length
earthwork for trap/basin
0 ft
cut at high side
height of dam at too
0 ft
height of fili at face
6 ft
length of dam
length of cut
tap width
0 It
(area above transition)
10 ft
)total width of tlam)
(area below transition)
(height below Transition)
0 ft
urea below transhion)
34 ft
length of spillway
(depth below 1-sitter
width of spillway
structures for basin
(area above transition)
0 sf
riser height
( tolal fill volume)
rear diameter
10 ft
barrel length
147 cy
barrel diameter
sift fence inlet protection (IP)
2.6 tons
stone inlet protection (IP)
outlet protection (OP)
length
channel (SCC, matted)
length
check dam
depth in channel
onstruaim entrance (CE)
0 in
wash rack
-. .
paved construction entrance
barrel collars
rip -rap, placed
depth
baffle length
width
survey and layout (price par 0.1 mi.)
acres
mobilization
0 ft
stream crossing (computed independently)
0 ft
pipe diameter
0 in
0 ft
cut at high side
6 ft
0 ft
cut at face
6 ft
0 ft
length of cut
30 ft
0 It
width of cut
10 ft
0 sf
(area below transition)
132 sf
0 ft
)total witlth of cut)
34 ft
0 ft
(depth below 1-sitter
0 it
0 at
(area above transition)
0 sf
0,0 cy
( tolal fill volume)
1463 cy
10 ft
(TOAL Cy estimate)
147 cy
4.6 If
(spillway stone tons)
2.6 tons
Oft
0 in
$9.99
0 ft
base plate or fdn
0
0 in
-. .
barrel collars
0
baffle length
0 ft
0 ft
width
0 ft
0 ft
width
0 It
0 ft
channel width
0 ft
0 ft
length
0.0 ft
0.0
ins)
0 ton,
1
traps and basins
1
No. Unit
Unit Cost
Cost
(installed)
0.5 acres
55.000.00
$2,500.00
260.0 ft
$5M
$1,300.00
0.0 ft
$5.00
$0.00
0 ft
$13.00
$0.00
$0.09
$0.00
I
cost sum
prq mgmt
contingency
Total
$1100 $1,911.00
$50.00 $130.00
$0.00
$200.00 $0
$0.00
$200.00 $0
$50.00 $0
$100.00 $0.00
$200.00 $200.00
$0.00 $0.00
$0.00
$0.00 $0.00
$2.000.00 $0.00
$2,000.00 $2,000.00
$3,500.00 $3,500.00
$60.00 $0.00
$1,000.00
$500.00
$0.00
$13,041.00
$1,956.15
$1.499.72
$16,500
11/6/2014
Internal Use Only
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Date Received: 7 Fee Paid:C �"�01 A L0/vlj
Noes
Received by:
Intake: Forward to Management Analyst
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REQUEST TO ESTABLISH A BOND
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APPROVED PLAN# P O ZO 1 0005G
PROJECT NAME: I i Q Top 4. `,%r°`1A
(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: ?g I0 A OWNER'S NAME: Y ASS A 105 LLG
SIGNATURE: I 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:
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;
EeVESCP 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;$250 fee required
❑ Subdivision(roads,drainage,etc.) per Subdivision Ordinance section 14-435;
&Water& Sewer per Subdivision Ordinance section 14-435;$250 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: Y-A--\--ct1/4CaY\..'5C7i '1Vt f 1 ( E) 1tiL
OR REGULAR MAIL ADDRESS: , i C n 1M.l1rt4%e
L,0 4 72-61 1.
Revised 6/20/2014 , CZA /Y1/ Jti . i --/ - d � J
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