HomeMy WebLinkAboutWPO202100038 Preconstruction Form 2022-12-09Request for Pre -construction Meeting and Grading Permit COW
from Albemarle County — VSMP
Approved Plan Number: WPO- WPO- 2021-00038 DEQ Permit # (if applicable): VAR10
Approved Plan Name: Southwood Redevelopment Village 2
(Plans must be approved prior to a pre -construction meeting.)
Bond approved date: 12-9-22
(Bonds must be approved and posted prior to a pre -construction meeting or permit.)
Responsible Land Disturber:
Print Name: WILLIAM THIESSEN —HABITATIOIR OF LAND DEVELOPMENT
State RLD Number:
Address: 967 2" STREET SE
City: CHARLOTTESVILLE State: VA Zip: 22902
Daytime Phone: (609 651-6404 E-mail: Wthiessen ancvillebabitat.ore
Primary Contractor:
Print Name: FAULCONER CONSTRUCTION COMPANY
Address: 2496 IVY ROAD
City: CHARLOTTESVILLE State: VA Zip: 22903
Daytime Phone: (434 ) 295-0033 E-mail: Brieckmann(a,faulconerconstruction.com
Permit Issuance Fees (Request must include payment) [Code §17-708J.-
Total acres proposed to be disturbed as shown on the approved plan and application: 4.88 Acres
e DisturbedMTotal
Due for Grading Permit
ation Fee+ 4% Technology Surcharge)
1
S74,88
($72 + $2.88)
ily Dwelling only—$74.88
Randless
($72 + $2.88)
than 5 acres
$700.96
han l0 acres
$881.92
($848 + $33.92)
10 and less than 50 acres
$1,167.92
($ I,123 + $44.92)
50 and less than 100 acres
$IMI,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).
V1/14, Revised: 8/29/14, 10/18/18, 7/l/2021, 7/26/2021, 9/15/2021 Page l of 3
Person(s) attending the Pre -construction Meeting:
Names (type or print) Firm Contact Number or email
WILLIAM THIESSEN HABITAT OF UV1LLE 609-651-6404 WTHIESSEN@CVILLEHABITAT.ORG
BRYAN RIECKMNN FAULCONER CONST. 434-964-6589
BRIECKMANN@FAULCONERCONSTRUCTION.ORG
RJ WRIGHT FAULCONER CONST. 434-906-5253
RJ WRIGHT@FAU LCONERCONSTRUCTION.ORG
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?