HomeMy WebLinkAboutWPO202100069 Preconstruction Form 2023-01-03QP
Request for
Pre -construction Meeting and Grading Permitfrom Albemarle County — VSMP
Approved Plan Number: WPO- 2021-00069 DEQ Permit # (if applicable): VAR10-
Approved Plan Name: Scottsville Tiger Fuel Market
(Plans must be approved prior to a pre -construction meeting.)
Bond approved date: 01/03/2023
(Bonds must be approved and posted prior to a pre -construction meeting or permit.)
Responsible Land Disturber:
Print Name: Meagan Agee
State RLD Number: RLD09789 194 Zen
Address: 210 Carlton Rd.
City: Charlottesville State: VA Zip: 22901
Daytime Phone: (434) 326-7167 E-mail: meagan@martinhorn.com
Primary Contractor:
Print Name: See abc
Address:
City:
Daytime Phone:
E-mail:
Permit Issuance Fees (Request must include payment) [Code §17-708]:
State: Zip:
Total acres proposed to be disturbed as shown on the approved plan and application: 3.49 Acres
Acres to be Disturbed
Total Fee Due for Grading Permit
Total Fee = (Application Fee +4% Technology Surcharge)
Less than 1
$74.88
$72+$2.88
Single-F ily Dwelling only_—
$74.88
less than 5 -, "' `'
- ($72 + $2.88
1 and less than 5 acres
$700.96
$674 + $26.96
5 and less than 10 acres
2
($ 848 + $33.92
10 and less than 50 acres
$1,167.92
$1,123 + $44.92
50 and less than 100 acres
$1,581.84
($1 521 + $60.84)
100 acres and more
$2,490.80
$2,395 + $95.80
Annual maintenance fees are assessed in arrears on April 1 each year or portion of a year that this permit is active
[Code §17-208].
7/1/14, Revised: 8/29/14, 10/18118, 7/1/2021, 7/26/2021, 9/15/2021 Page 1 of
Person(s) attending the Pre -construction Meeting:
Names
Firm Contact Number or email
Meagan Agee Martin Horn 434-326-7167
Chris Marshall Shimu Engineering 434-227-5140
The second part of the application fee is required to be paid with this request. This fee amount is:
FOR OFFICE USE ONLY Permlt Issued Date
By who?
7/1/14, Revised: 8/29/14, 10/18/18, 7/1/2021, 7/26/2021, 9/15/2021 Page 2 of3