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HomeMy WebLinkAboutWPO201300029 Bond 2016-03-03 Internal Use On! �/� �/� D 2l- 20 �e Date Received:�" U✓`bs/ Fee Paid: / I/ Received by: &1L - 'ra i 4gianagment Analyst allithp�j 46 NM* VOW 1":646/14.. Pi9d4-1;2426Pt9 V—/12196 REQUEST TO ESTABLISH A BOND APPROVED PLAN# SDF201SC OdZY/we&2013 00029 PROJECT NAME: AL-139.F C kt7 PLA E (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. 06AOO .I{ l Mi TAX MAPs/PARCELs: MOO)Eto OWNER'S NAME: 1 N ISLE SIGNATU• • "ay.//Chrilfj, date TAX MAPs/PARCELs: 0 I ER'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; ESCP Erosion&Sediment Control per Water Protection Ordinance section 17-207;$0 fee l,�/VVSMP 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;$250 fee required A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please provide contact information EMAIL: y E�CDC5IbhigN•V1 .04,$ . • G OM OR REGULAR MAIL ADDRESS: '•SS IA svtcs+enA-Cit Revised 6/20/2014 f 4 hi N m M 4s k O (Nt � `k 4111.11 69\ 1 .b ri N 64) 0 (41 0 1.i.N 411 U Nt,\ CO A . it..is0 01E 11,11 a4cz lib T. o 0 SA• N N ,' O Ln cu ,..4.,� 4tt cNi 1111, C3 O O. 4� T ` •• • te4. _ O 6a ' u, g ..k16" ' 111'' N. I , 0 ,44066. ' .., ..,4 !Al 1 vW ur A Y 6 oml S wtz 0, iii...., Ix (0u, f. • v � 1 - o Wcc Z a, Nil. M rg 0 J o� v» a o� a ,0 O 08 Ln o a a .. A C, w o w° i' =LL , • C..) j ►-o aoW a0 0