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HomeMy WebLinkAboutWPO201400072 Bond 2015-02-11 Internal Use Ong y�r� Date Received: `0 15_ Fee Paid )ti F AL i Received by: K�� �$^_',t!�111�(I�v Intake: Forward to Management Analyst I IRGI14l?- REQUEST TO ESTABLISH A BOND APPROVED PLAN# PROJECT NAME: CHICK-FIL-A (STORE#03187) (As listed on the approved plan) 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. TAX MAPs/PARCELs: 78/55A2 OWNER'S NAME: CORVEN D. AND KATIE H. FLYNN SIGNATURI R' Z7. a � 7 t ate: 2/11/15 TAX MAPs/PA CELs: 78/55A8 OWNER'S NAME: THE MARKETPLACE OF VIRGINIA, LC SIGNATURE: date: TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date: TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: date: TAX MAPs/PARCELs: OWNER'S NAME: 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 submitted certifying that the person signing above has the authority to do so. The requested estimates are; ® VESCP Erosion & Sediment Control per Water Protection Ordinance section 17-207; $0 fee ® VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water Protection Ordinance section 17-208; $250 fee required ❑ Subdivision(roads, drainage, etc.)per Subdivision Ordinance section 14-435; &Water& Sewer per Subdivision Ordinance section 14-435; $250 fee required A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please provide contact information. C/O EMAIL: james.dunn @hdpc.net OR REGULAR MAIL ADDRESS: Revised 6/20/2014