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BOND INSPECTION REQUEST
APPROVED PLAN #: SUB202100179
PROJECT NAME (including Phase #): Galaxie Farm Subdivision Road & Utility Plan (Phase 1)
(As listed on the approved plan)
This form is used to request a reduction or release of a bond. A fee is required for each inspection. Please
check the appropriate box below for the requested inspection(s). Fees includes 4% Technology Fee.
Inspections for the purposes of bond reduction or release will require a separate fee for each bond.
❑ VSMP/VESCP Erosion Control, Stormwater Management and/or Mitigation per
Water Protection Ordinance sections 17-207 & 17-208 $294.32
o Reduction ❑ Release
❑ Subdivision (roads, drainage, etc.) per Subdivision Ordinance sections 14-435 & 14-438 S307.84
11 Reduction ❑ Release
® Water & Sewer bond per Subdivision Ordinance section 14-435 S307,84
10 Reduction ❑ Release
❑ Site Development Performance bond (Incomplete Site Work & Landscaping) $344.24
❑ Reduction (site work only) ❑ Release
TOTAL FEES $307.84
Submit requests to: Department of Community Development, 401 McIntire Road, North Wing, Charlottesville,
VA 22902, Attention: Program Administrator — Phone 434-296-5832. All roads and stormwater facilities will
require construction record drawings", inspection reports, videos/photos, plats/esmts, certifications, and
completion processes through VDOT or DEQ (refer to County acceptance procedures). Bonds will not be
reduced or released without record drawings and inspection documentation per the state requirements and
County's published procedures. A minimum 20% of the original posting is held until acceptance of all bonded
improvements. For Site Development Performance bonds, if landscape installation is part of the bonded site
work, a request for reduction should only be made once all landscaping is complete.
If all required documentation is not received within 30 days of receipt of this request, this application shall be
deemed incomplete and shall be rejected. If rejected, a new application, supporting documentation and fee will
be required. Applications may be withdrawn for a full refund within 30 days of receipt.
If this is a reduction request, the revised estimate will be prepared by the plan reviewer and sent to the owner.
Please provide contact information.
EMAIL: simpson@riverbenddev.com
OR REGULAR MAIL ADDRESS:
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2/1/2023
Date
• Note: A one -tune VSW record drawing (As -built) review fee is required.
Revised 7/l52014, 7202015, 11/32015, 8/14/2017, 1282020, 7/12021, 8/312022, 1/122023