HomeMy WebLinkAboutWPO201500078 Bond WPO VSMP 2017-04-07 I . PM "7464 d q/Z/Za")--
Internal U1/Olds / // �/ OF
Date Received: l i F Paid: 9 ` °I f 7/n 0 t S /f(a)2k1
o Received by: I 8':.-.P7‘..2"6"14.11 , n P u�„
Intake: Forward to Management Analyst �f/� / I+J� eltiolv&
friRG1NVP / / .
/ ./4
REQUEST TO ESTABLISH A BOND
APPROVED PLAN # COTS 20)N-DO`66- WPC 20/ 0007
PROJECT NAME: NOVNI4A. PO d Nd1)e E vee-e ,4- 126 Zw
(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:,32-020 OWNER'S ME: G j A is. 6Ti✓ wAV I,Q
SIGNATUR date: Vr7 7 y
TAX MAPs/PARCELs: OWNS 'S NAME: Asst-SeG (��{'bt/L or,--
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, 6
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: Cj\
t�
VESCP Erosion & Sediment Control per Water Protection Ordinance section 17-207; $0 fee Cp
tiLVSMP Erosion and Sediment Control, Stormwater Management and Mitigation per Water
Protection Ordinance section 17-208; $250 fee required
Subdivision(roads,drainage,etc.)per Subdivision Ordinance section 14-435;
VVV��_& 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.Q
Ali li) ell GI e t . 60,v2
OR REGULAR MAIL ADDRESS: 26/g '1 aiu f - V
G I fA the Vet- 2Z °/
Revised 6/20/2014, 11/3/2015