HomeMy WebLinkAboutWPO202200002 Bond 2022-12-12Internal Use Only � rr��
Date Received: 2 Fee Paid�_4"1/ .3L—
Received by:
Intate: F yard to Program Administrator
APPROVED PLAN #
PROJECT NAME:
is
REQUEST TO ESTABLISH A BOND
-2D22-
(As listed on the approved plan)
I'ec. a7h GZ N
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.
]�32-23k TAX MAPs / PARCELs: 3Z." Z3 4 OWNER'S N ME: l(lart)% Nixie— 6y I I — U.C..
SIGNATURI 2 — date: ZZ
TAX MAPs / PARCELS: 32- 23 Q 3 OWNER'S NAME: f%t, P0i-% 11 'e C-v%. Ike L-(.C.
SIGNATURE date:
TAX MAPS / PARCELs: a2- 23al OWNER'S N E: LVo,f*A- ^f.tyd;? &v-Ne-I L, V-
SIGNATURE: date:
TAX MAPs / PARCELs:
TAX MAPs / PARCELs:
OWNER'S NAME:
SIGNATURE:
OWNER'S NAME:
date:
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 submittedertifying that
the person signing above has the authority to do so. S« A Iil7tct,C
The requested estimates are; (Fees include 4% Technology Fee)
❑ VESCP Erosion & Sediment Control per Water Protection Ordinance section 17-207; $0 fee
4 ( 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: �1� �OIJ fyt - G �US5 IG. CO✓✓1
OR REGULAR MAIL ADDRESS:
Revised 7/1/21