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HomeMy WebLinkAboutWPO201600050 Bond WPO VSMP 2017-04-07 - lidesaLliafiats a .dtAt10--' - ' . Date Received: S ICJ,.t� Fee Paid: d Received by: .,..4 : } // Intake: Forward to .nage Best Analyst ! ��'Y� iliicitat` r. .t.Lel V.'4413CO °..'"F trMilt REQUEST TO ESTABLISH A BOND . -. APPROVED PLAN# Sgegt9444881118. (.)r G 2 0( (o -Cao S o PROJECT NAME: Bria►wood Recreation Area (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. 032G-00-00-00100 TAX MAPs/PARCELs: OWNER'S ��NAME: Woodbriar Associates SIGNATURE:,, =-ye_dii 0,,4�" date:04/07/2017 TAX MAPs/PARCELs: OWNER'S NAME: 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; 0 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;5250 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: ulcvwvw©embargmail.com OR REGULAR MAIL ADDRESS: PO Box 5548 X Charlottesville,VA 22905 Revised 6/20/2014 ►, r COMPANY 25861 UNITED LAND Ct RP J N CHARLO� va gi } CONSTRUCTION A } P.O.BOX 5548 CHARLOTTESVILLE,VA 22905 (434)975-3334pAY TO THE ORDER OF CSa�A`F ,DA (f $ a . Ob � o DOLLARS MEMO —_--- nlr 11'0 258610 I:05 L404 2601:0005 L37 ? 2 237411' THIS DOCSIMENT CONTAINS A COLORED BACKGROUND ON WHITE PAPER.MICROPRINT IS LOCATED BELOW THIS WARNING BAND. County of Albemarle 109687 Department of Community Development � PH: (434)296-5832 Date RECEIVED F' •M: 41_61 /1,0 307 308 OtiL0 510 check ��l(Jl�� For: op° cash redi and :y /� /�