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WPO201700037 Bond WPO VSMP 2017-11-16
4,...„,,,„2., / 1' •� l�C n /we • Dote Receiv �/,.._ yF«Paid: �a ,(�A% Received►y: e b/ a, �l GFJ6 Intake: Forward to Management Analyst ��l u�e����"" REQUEST TO ESTABLISH A BOND APPROVED PLAN# WP0201700037 PROJECT NAME: Brookhill Section 1 Block 4A and Block 8A (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:04600-00-00-01800 OWNER'S N• : augh,k harles ' &E J Oglesby JR Trustees Contract Purch., SIGNATURE: AIL date:441_1 TAX MAPs/PARCELs: 04600-00-00-01900 OWNER'S N Croc tt Coyoration C/O Hau_h&Helvin Contract Purch Alan a; or ©l, SIGNATURE: ��/ date: 1 TAX MAPs/PARCELs: 04600-00-00-018A0 OWNER'S NAill Haugh, .i e J Oglesby JR Trustees Contract Purch.• an Ta ( SIGNATURE: date: (,) �"i t 1 '7 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; 1231 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; $269 fee required A bond estimate will be prepared by the plan reviewer. The estimate must be sent to the owner. Please provide contact information. a`" EMAIL:ryauger@bohlereng.com �1�`' At C OR REGULAR MAIL ADDRESS: Bohler Engineering VA,LLC Att: Ryan Yauger,P.E. yA / 4��� Av\\) 28 Blackwell Park Lane,Suite 201,Warrenton,VA 20186 \, V Revised 6/20/2014,11/3/2015 ^ ✓, `