HomeMy WebLinkAboutWPO202200039 Preconstruction Form 2022-11-17Request for Pre -construction Meeting and Grading Permit
from Albemarle County - VESCP is
Approved Plan Number: WPO-_ ? Cq2_ - c*,ep� SIT
Approved Plan Name: � ?4X-A TWn�,C�"A 0 V9
(Plans must be approved prior to a pre -construction meeting)
Bond approved date:
(Bonds must be approved andpostedprior to a pre-comtruction meeting orpermit.)
Responsible Land Disturber:
Print Name: &A�- �,Yln�
State RLD Number:
Address: 04 St
city: rin��C. State: Ok 7ip: '224t
Daytime Phone: C&(a� E-mail: VVAk VOUNXgj 6paA ca�
Primary Contractor: U
Print
Address: U
City:
State: — Zip:
Daytime Phone: ajA) t�"c> E-mail: 40114 6) QUMA= Akdka. co-n
d U
Pennit Issuance Fees (Request must includepayment) [§17-2071:
Total acres proposed to be disturbed is contained on the approved plan and application:
Acres to be Disturbed
Total Fee Due for Grading Permit
Total Fee = (Application Fee + 4% Technology Surcbarge)
Less than 1 acre
$176.80
($170.00 + $6.80)
1 or more acres
$353.60 Per Disturbed Acre or Portion
($340 + S13.60) -2. V A
Annual maintenance fees are assessed in arrears on April I each year or a portion of a year that this permit is
active [§17-207].
9/11/2017, 7/1/2021, 9/15/2021 Page 1 of 4