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REQUEST TO ESTABLISH A BOND aZS 34 5
APPROVED PLAN # 41-,017D603-90 U 06‘)/v3
PROJECT NAME: & O ) ,g/o /(/ LOTS 0‘---',=2,31
(As lige on the approved p and ) f /
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.
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TAX MAPs I PARCELs: . G-4/'/4: OWNER'S NAME: Jz4 ,'h2/17
SIGNATURE: 41141 date: i/ '/i
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TAX MAPs/PARCELs: e //" OWNER'S NAME: !/,' �yi11//gym 22, r,P.,g1
SIGNATURE: kali., ,(/ date: 8%I' /
a f q&:‹2r '/17/SFS,
TAX MAPs/PARCELs: OWNER'S
-Q//I- OWNER S����N����AME: ,D, s;�
SIGNATURE:A/14 date: 8/44 ." /
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
❑ Subdivision(roads.drainage,etc.)per Subdivision Ordinance section 14-435;
& Water& Sewer per Subdivision Ordinance section 14-435; S269 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: te)iJ/, 'r� (a)&4/.gadiers, ne�' /11-7;)1'l9e2<6/69/
OR REGULAR MAIL ADDRESS: / C-1, /30x �p�6
Revised 6120/2014, 11/3/2015
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER AND ORIGINAL DOCUMENT SECURITY SCREEN ON BACK WITH PADLOCK SECURITY ICON.
CRAIG BUILDEt UNION BANIc 4UsT 78984
P.O.BOX 6156
CHARLOTTESVILLE,VA 22908
68-318/514 August 15, 2017
PAY
TO THE County of Albemarle
ORDER OF $ 250.00
Two Hundred Fifty and 00/100 *„*** „.......,*******,.«***„*.,..*.,«*.**.******.***.*.,*,►*.,,.,,a.****.,.,***.***...**.
DOLLARS
401 McIntire Road
Charlottesville, VA 22901 USA CRAIG BU --
MEMO OTVH16.26-28 VSMP...
AUTHO- ED•GNATURE
H4078913 lie 1:0 5 14031641:4206940r
County of Albemarle 110 777
Department of Community Development
PH:(434)296-5832 Date f j f:' ��
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RECEIVED FROM I •
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307 3138. 324 510 check f '' f c‘
For: cash
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per.
Ana Kilmer
From: Geoff Elsie
Sent: Thursday, August 31, 2017 3:31 PM
To: Ana Kilmer
Subject: WPO2017-00059 Craig Builders Bond estimate
WPO 2017-00059 Old Trail, Block 16, Lots 26-28
Bond amount is 4000.00
Land Distrubance is .25 Ac.
TMP's have been verified as owned by Craig Builders.
Geoff Elsie
Engineering Inspector
Albemarle County
gelsie@albemarle.org
(434)270-3471-Cell
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