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HomeMy WebLinkAboutSUB202100179 Bond 2022-11-09Internal Use Only Date Rtteived: Fee Paid: A Received by: �J fir Intake: Forward to Program Administrator REQUEST TO ESTABLISH A BOND APPROVED PLAN # SUB2021-00179 PROJECT NAME: Galaxie Farm Subdivision Road and Utility Plan (Phase 2) (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: 91-15 OWNER'S NAME:/AblaA4e arrnkkestments. LLC SIGNATURE: / _ T,0 W/\,/ date: I 14 /q,---- TAX MAPS / PARCELs: OWNER'S SIGNATURE: TAX MAPS / PARCELs: TAX MAPS / PARCELs: TAX MAPs / PARCELs: OWNER'S NAME: SIGNATURE: OWNER'S NAME: SIGNATURE: OWNER'S NAME: SIGNATURE: date: date: 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; S294.32 fee required 12 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: simpson@riverbenddev.com. OR REGULAR MAIL ADDRESS: Revised 7/1/21 From: Albemarle County - VA - Tax no-reply(sturgiswebservices.com Subject: Payment Submitted Date: November 9, 2022 at 2:07 PM To: Tucker.loydgriverbenddev.com • Albemarle County - VA - Tax PAYMENT SUBMITTED! Transaction ID 2211091307657BD7A313A Total Paid $315.54 Item Amount Item Number: 6625BF $307.84 Type: Community Development Other Notes: Galaxie Farm SUB202100179 - Request to Establish Bond Transaction Fee $7.70 Total $315.54 !g i