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HomeMy WebLinkAboutWPO201500033 Bond Estimates 2015-09-24 r)b i� Internal Use Onlv _ �C7p�p eU 10/LC/24°75 � Z p Daete Received: a 1 7Fee Paid:C ii l Received by: A5 VVV/ 4�� r1� 0 1 mentAnast 114,49/1-01 SA) 44-;v.-11-4e4C / REQUEST TO ESTABLIS A BOND v APPROVED PLAN# w'PO2oIsOoo33 � �-; �;'� �4 �' ., . (; ../117-7"-1 PROJECT NAME: g l I broe k (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:1 W 9 — 114 OWNER'S N E:1, SjJw• � tti O4t111y '�4!}G-cvS) U.G) SIGNATURE: Lv,4 L date: q Z3/I c TAX MAPs/PARCELs: OWNER' AME: 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 I"VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water Protection Ordinance section 17-208;$250 fee required /Subdivision Subdivision(roads, drainage,etc.)per Subdivision Ordinance section 14-435; & Water& Sewer per Subdivision Ordinance section 14-435;$250 fee required A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please provide contact information. f EMAIL: J-eS5 real ott r` CQ-V. Co OR REGULAR MAIL ADDRESS: P. b. 13.)( (0L15 CA4r1t,4e-svItk1 ✓A, 22 0Z Revised 6/20/2014 < . . SiimisW to o to TO 888888 888888888 8 88 8 88888 8 ° a§§ 2f© l'i M /S` (# k §/R§# " :2jk j `& 2 g; k °■a; \\\ \ 888888 888888888 8 88 8 888 of «\,,,. 2§[&mm5\; j § § \\\ , , ,. ,c. 89 \ ( ( ) \ 0 -02„.„ §«2 °° £e ! , , , : f == c = , ! != .. , - § , 88 ,s, / k t ! - ! | / f)!\ ) ! ± /` q \ {} f \ i I {\ | , o o oo,o o o , } { 1 8 / §! | { Zri � ; !7} = 7 2 - E: ; {{33 i \ \ - { k / � , ! !! \ R � { { _ ! t � � f \ } a t'= . k ) k ® \ ;k [ ! { {1 { Xf & 1-02ii ,® � r ® i . !\f ! � a2 k \{ ; . {� ) 7 ; 1 f§ ) ) ! \ EE E r ! ` f ® ! E ' t! ! ! ! y | ! ! - _ ! ! zca f alf ; !$ ! / ¥ ] $! | ` E- , !!! § ) § ` | | 2 ; . . . 2 § EE a. “5 ! ' .. ilerie . o (N iii \ � 88 88888888 8 888 \\L \\\\ 88 \ of 88 88 /) \j j\ \ 5 ) . " ° / 2 ,2F- „;, ! ^ ; o " § ` - k _ {{ { { - {§ {{\ \§ (! f{§ \ 115f1 > § � : il § 2 8 _ _ kj \ - \) ! I \� - I E _ _ / _ - _ B ) ) e 42\\ � ~ : \\ E 2 E % k ){! f {{; 1, ; _ \ : : , , U , \ , c3 ) 'a 0. W $\