HomeMy WebLinkAboutWPO200600064 Bond 2007-12-19 Internal Use Only L y
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BOND
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BOND INSPECTION REQUEST
(Inspection must be requested by the Owner/Developer of the property)
DATE: VPC'_ 1'. C
/11
PROJECT NAME: •l ,'/2t' `� a�
(Include phase,section,and other relevant information to clearly identify the project)
11
TAX MAP/PARCEL: it7/ - l'`�( OWNER: IlUg 1eY N-11 r 4 Y.c.i Z'-: n(e', L
This is to request that an inspection be scheduled to determine if the following performance bonds can be
reduced or released(check below all that apply). Requests are required once the initial bond estimate is
prepared. Requests should be submitted to: Department of Community Development,401 McIntire
Road,Room 227, Charlottesville, VA 22902,Attention: Pam Shifflett-Phone 434-296-5832; Fax
434-972-4126.
Inspections will be scheduled within thirty days of receipt of this request and the required fee.
❑ Water Protection Performance Bond (at least 30% of the work must be 1)r), , -.00007
satisfactorily completed before requesting an inspection for reduction)
tr Erosion& Sediment Control Lam'(' Stormwater Management& Water Quality _ `.\
❑ Subdivision/Road Performance Bond (at least 30% of the work must be ' ti is G,ODD
satisfactorily completed before requesting an inspection for reduction)
SUBMIT $60 BOND INSPECTION FEE PER BOND - make check payable to the County
of Albemarle and submit with request.
C_ Roads & Drainage 4ffttd-*j P'C OF 3
"Water& Sewer ,: 1 tI f
❑ Other-list below(i.e. landscaping, pedestrian paths)
❑ Site Development Performance Bond-Incomplete Site Work
SUBMIT$60 BOND INSPECTION FEE PER BOND-make check payable to the County
of Albemarle and submit with request.
If landscape installation is part of the bonded incomplete site work, a request for reduction
should only be made once all site work is complete and the project is ready to start the one-
year landscape maintenance period. Bonds for landscape maintenance are 33.3% of the total
landscaping value and are maintained at that amount for the one-year maintenance period.
Signature of Owner/Developer fah. �T�`` I �� /C11
Phone
11/110,x,e,- ( • Pe-ix e-I
La tia.424-
Print Name Tale
File:I:\DEP71ENGINEFRTORMS\BONDS\Bond Inspection Request Form.doc
1/1/n1 a... i/77/n4 5,. 1110/04 R.., 7/7/MA