HomeMy WebLinkAboutWPO201700037 Preconstruction Form WPO VSMP 2018-07-06 SPCRC6C\ "1 /31 I Ig'
Request for Pre-construction Meeting and Grading Permit f
from Albemarle County
Approved Plan Number: WPO- La 11 (5 FS 7 7
Approved Plan Name: 73 r.o,. t- 2 bI c. -ti -- 1 � 310 't A- a.._4 6A
(Plans must be approved prior to a pre-construction meeting.)
Bond approved date: 7/&111
(Bonds must be approved and posted prior to a pre-construction meeting or permit.)
Responsible Land Disturber:
Print Name: CONfowv Consfratelleo LLC. / SLdd. S"4-P/MOIXANN "c1,1:&5.)iN
State Certification Number: R LD 062.2-Y
Address 1713 /411i as Sfrs+f'
City Cl.,.v1.fres,,;uc State VA Zip 229'02
Daytime Phone(Y3y) 2Yy— 0001 E-mail 51161o1afd-quriNSkr C+:c, vNe 4
C
Primary Contractor: an-{o.AC'Ma� � a o ,Co..A \
Print Name C0144n+.w CdNci-rtavii'or► (-(
Address 1713 / /ht1 560e4.1-
City
t0e.e+City C14 owl*#05 e. State OfZip 2.1Qo 2.
Daytime Phone(in) Z(elf-(200 I E-mail
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
l and less than 5 $594.00
5 and less than 10 $748.00
10 and less than 50 $990.00
'14- 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
Person(s)to attend the Pre-construction Meeting:
Names(type or print) Firm
Contact Number or email
iseoA 1wl,So''\ A c S `/ - RS1 - 363
(Vi icJ\ (--E-a v) R iferb `U4/ - 1,6c - 15G
d „� \(�u)e lel e 5 -1`t�`t 47, 738'
3557'
The second part of the application fee is required to be paid with this request. This fee amount is;
FOR OFFICE USE ONLY Permit Issued Date
By who'?
7/1/14. Revised: 8/29/14 Page 2 of 3
Project Name: Brookhill Section 1, Block 4A&8A Project/WPO Number WPO201700037
Tax Map Parcel 46-18,46-18A,46-19 DEQ Permit Number(if applicable)
Land Owner/Contact Brookhill Investments LLC.P.O.Box 1467 Contour Construction LLC.
Charlottesville VA,22902 Site Operator/Phone
(434)244-0001
Qualified Personnel/phone Joe Simpson-(434)981-3634 Principle Contact/phone Sheila Scott(434)244-0001
Contact E-Mail: Simpson@riverbenddev.com RLD name&Number Contact info Contour Construction LLC.
(434)244-0001
Inspector: Jonney Otto-434-981-5154 Nutrients Credits 0
Disturbed Acrage: 47