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请在此表格中包括150美元的申请费，应支付给夏洛茨维尔市。Construction Activity Operator (1) : Name: _______________________________________________________________________________________ Contact: _____________________________________________________________________________________ Mailing Address: ____________________ ___________________________________________________________ City: _____________________ State: _____________ Zip: _________________ Phone: _____________________ Email Address: ________________________________________________________________________________ Project Information: Project Name: _________________________________________________________________________________ Building Permit No.______________________包裹ID（9数字＃）：__________________________批次：_______ _______总站点区域（平方英尺ft。或英亩）：__________________总计干扰区域（sq。我进一步同意邻里开发服务部必须确定的其他要求。此类要求应基于所需的最低标准，以提供对这一发展产生的侵蚀和沉积的充分控制。ft. or acres): ___________________ Address (if no address, description of location): _______________________________________________________ ____________________________________________________________________________________________ City: _________________________________ State: _________________________ Zip: _____________________ Identification of Responsible Land Disturber (2) : Name: ________________________电话：___________________电子邮件：________________________________证书编号：__________________________________________________________________________________________________________________________________________代替了此类的侵蚀和泥沙控制计划，我同意根据弗吉尼亚的控制要求，并同意，并同意AM的要求，并同意AM的要求，并同意AM的要求。凭借最新的弗吉尼亚侵蚀和沉积物控制手册标准和规格，以防止土壤从该物业中运输出来。
协议代替侵蚀和沉积物控制计划
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