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HomeMy WebLinkAboutWPO201400008 Bond Request 2014-06-20 r&Cid s/O.' "S Internal Use Onl Date Received: 1 'ee Paid: IWOReceived by: ic Intake: Forward to N. agement Analyst 0 j u�- 11109, YY) NGIO ALei/j_e_ REQUEST TO ESTABLISH A BOND P �7► '"`� APPROVED PLAN# uvPo - 701 - ObOb$ PROJECT NAME: Giro 7' 7 T7g t3 UP1/4//4iej (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. ,l f� TAX MAPs/PARCELs. e OWNER'S AME: f 4-0.7{t- Cup,../. Yot /f SIGNATURE: , '{.' date: 41 TAX MAPs/PARCELs: OWNER'S . SIGNATURE: ' TAX MAPs/PARCELs: OWNER'S NAME: SIGNATURE: +'^ Par)6 -\N/JL.Sk S TAX MAPs/PARCELs: OWNER'S NAME: 3 SIGNATURE: TAX MAPs/PARCELs: OWNER'S NAME: C SIGNATURE: ✓ e - � � NOTE: If ownership of the property is in the name of any type c5ctUt,uS r including, but not limited to the name of corporation,partnersh � /- w trust,association,etc.,documents acceptable to the County mus the person signing above has the authority to do so. I hQ --ke"111 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 E 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 he prepared by the plan reviewer.The estimate must be sent to the owner. Please provide contact information. / J EMAIL: /7011 e OR REGULAR MAIL ADDRESS: Revised 6/20/2014 TO jl Internal Use Only rlA14 .(� Date Received: a.. Zi /Fee Paid: �1�`i fr Received by: talWAittLe a111ki Intake: Forward to n:cmentAnalyat !! REQUEST TO ESTABLISH A BOND APPROVED PLAN# WPO-2014-00073 PROJECT NAME: South Rivanna WTP - GAC Upgrades (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: 45-68B OWNER'S 74 !R :,: .- -tpr & sewer Authority SIGNATURE: 441 I, `. date: ;11, TAX MAPs/PARCELs: OWNER'S 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; SO fee ® VSMP Erosion and Sediment Control,Stormwater Management and Mitigation per Water Protection Ordinance section 17-208;$250 fee required 0 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. EMAIL: dmarch®rivanna.org OR REGULAR MAIL ADDRESS: Revised 6/20/2014 FD . 4C( 1/20/s more `yaw' Internal Use Only $° A Date Received: Fee Paid: �~OY L l Received by: ' 11). )172,11 Intake: Forwar to M- agement Analyst aro' '��w 4112: )1,04..e._ di; REQUEST TO ESTABLISH A BOND APPROVED PLAN# WPO-2014-00069 PROJECT NAME: North Rivanna WTP - GAC Upgrades (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: 32E-1A OWNER'S NAI IE:1Riyd nirca vat r Sewer Authority SIGNATURE. , t = ! ';' date: 4. { 19- TAX MAPs I PARCELs: OWNER'S NAME: I !! SIGNATURE: 1 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. EMAIL: dmarch@rivanna.org OR REGULAR MAIL ADDRESS: Revised 6/20/2014