HomeMy WebLinkAboutWPO201700076 Preconstruction Form WPO VSMP 2018-04-24 of At
Request for Pre-construction Meeting and Grading Permit �''i�►y
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from Albemarle County AP
Approved Plan Number: WPO- 2017 boo?(„
Approved Plan Name: Unkre;l /1 l/t jir jinrei("�u�1ci�(?c �Tc�tU(�lYurL Go 11(aetv, Coyvec:(U-- bad
(Plans must be approved prior to a pre-construction meeting.)
Bond approved date: 4/Lid-/ I
(Bonds must be approved and posted prior to a pre-construction meeting or permit)
Responsible Land Disturber:
Print Name: t)hl l la ,.)Ico i-t- Ieon C.
by r LO rI S�"Yl l C�'1 L�`") i
State Certification Number: R LD C)6 2.2-41--
Address
Z4Address (2,11a1 7 15 - 2 6I 1/cc( 6-et 1
City I, a 1*'svl Ile State Un Zip 22903 2 03
Daytime Phone(434-) L-626 —1 qe o E-mail he.-i he.- la 60 eon y"( 9 lj l }'L-1 E,-/Or)
Primary Contractor:
COrint Name Ciill-DIA Ir' (.'.oils I 'iid or) 1 Li__
Address ( ( 1 J•- r e Pi(1 Cr.+ 511 ee I--
City a ha/f P j es V i I /e State V Zip 2-2—(103
Daytime Phone(04-) 4-66) • Icl8() E-mail 5hei la 6.0 Con t-Durcwins/ 2(G�-roil • i1�
Permit Issuance and First Year Maintenance Fees: (Request must include payment)
Total acres proposed to be disturbed is contained on the approved plan and application:
VSMP:
Acres to be disturbed Fee Due at Grading Permit
Less than 1 $63.80
1 and less than 5 $594.00
5 and less than 10 $748.00
10 and less than 50 $990.00
50 and less than 100 $1,342.00
100 and more $2,112.00
For plans exempt from VSMP,VESCP fees were paid with the application.
7/1/14,Revised:8/29/14 Page 1 of 3