HomeMy WebLinkAboutWPO201600026 Bond 2016-05-14 Patrol Use Oal' rtnr ���
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REQUEST TO ESTABLISH A BOND $ , i athilLeAtp
APPROVED PLAN # ORO 2CW°° —co zL
PROJECT NAME: l—1 i C ICS ZS tO Gr-LC
(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: 11'47)7 y/5;4OWNER'S NAME: 7 /" ✓ /7.5C 4
SIGNATURE. �`. --'� �//
date: �� �
TAX MAPs/PARCELs:1 P 9 V-/ i4 OWNER'S NAME: 4.. //--/'9 L° /7(6‘/ ,/
SIGNATURE: Z.4,, o�- 2 7
date: '/oL7/7C
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;
KVEErosion& Sediment Control per Water Protection Ordinance section 17-207;SO fee
SMP Erosion and Sediment Control,S er Management and Mitigation per Water
Protection Ordinance section 17-20 ;$250 fee aired
0 Subdivision(roads,drainage,etc.)per Subdivision Ordinance section 14-435;
& Water&Sewer per Subdivision Ordinance section 14-435;$269 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: 300-0 ,_(,C� Dcs,14tryo/U C 0S7orl� ,C&-(
OR REGULAR MAIL ADDRESS: 72 c //7, �V74--
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Revised 6120/2014,11/312015