HomeMy WebLinkAboutWPO201700076 Request to Establish Bond WPO VSMP 2018-03-30 . . ,, ,. ..H.
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Date Received: Fee 1%Paid: ) 60
Reerivell by:
Intake: forward to Management Analyst
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REQUEST TO ESTABLISH A BOND
APPROVED PLAN # WP020 i 7 k07 (. .
PROJECT NAME: UVAF Temporary Golf Course Connector Road
(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.
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TAX MAPs/PARCELs: _75- 3 OWNER'SpirE: U to7-5//71 6/- LI,9//1 fa. rairlaa' 641
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:
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;
O VESCP Erosion & Sediment Control per Water Protection Ordinance section I 7-207; SO fee
✓ VSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water
Protection Ordinance section 17-208;$250 fee required
O 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.
EMAIL: O eliOQ_Ieze Loza ncia I-ion,Co In
OR REGULAR MAIL ADDRESS: P.0. 156)( 10002-7
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Rod.ed 6/20/2014. 11/312015