Fillable Printable Bond Release Request Form - Charlotte

Bond Release Request Form - Charlotte

Final Inspection/Bond Release Request Form

Please note, form must be fully completed. Incomplete forms will not be accepted.

Bond Administration Surety Release Request

As the authorized agent, I hereby complete this section as my formal request for the release of the following surety

associated with the subdivision/project/map below: Please check only one Box

□ Sidewalk □ ROW □ BMP □ Other ________________________

□ Subdivision □ N/A - If no bond is associated with this subdivision/project/map

Is this surety greater than four (4) years from the original effective date? □ No □ Yes

If yes, the $440 bond administration fee must be submitted with this form. The request for release and final

inspection will not be processed until payment is received. Please note, this request and fee are valid for 90 days.

If the surety is not released within 90 days of the form submittal, another Final Inspection/Bond Release Request

Form and applicable bond release fee will be required prior to surety release. Annual renewal fees are not waived

by requesting a bond release. The release must occur before the surety’s annual renewal date.

□ Payment Enclosed Payment Method: □ Check (made payable to the City of Charlotte) □ Credit Card (Visa or

Mastercard)

Continuous Maintenance Request (Streets) – If subdivision or N/A box is checked, check only one box below:

□ I hereby request that the City of Charlotte accept these streets for public maintenance. The streets are located within the limits of

the City of Charlotte and are contiguous to streets currently maintained by the City or State.

□ I hereby acknowledge that the streets are located within the extra territorial jurisdiction (ETJ) outside of the limits of the City of

Charlotte and are not eligible for maintenance by the City of Charlotte. Upon completion of all punch list items, I must directly

petition the State of North Carolina to accept the streets for public maintenance.

As a prerequisite to Subdivision or BMP requests for Final Inspection, Storm Drainage and/or BMP as-built

drawings for this subdivision/project/map must be approved by Engineering and Property Management.

Approved as-built permit number: LDAB ___________________

Final Inspection Request Inspector Name_____________________________________________

As the authorized agent, I submit this form as my formal request for the City of Charlotte to begin the Final Inspection process for:

Subdivision/Project/Map Name________________________________________

Phase _____________ Map _____________

I hereby certify that to the best of my knowledge, with the exception of specific final punch list items resulting from the requested final inspection,

which will be satisfactorily completed prior to any surety release and/or transfer of street maintenance responsibility, all public improvements for the

subdivision/project/map listed above have been constructed in accordance with the approved preliminary plan and corresponding to a record map

filed in the office of Mecklenburg County Register of Deeds. All work conforms to the construction standards of the City of Charlotte Engineering

and Property Management, Charlotte Department of Transportation (CDOT), North Carolina Department of Transportation (NCDOT) and the City of

Charlotte Subdivision Ordinance. The map has been recorded with the Mecklenburg County Register of Deeds in

Map Book _____________ Page _____________

Authorized Agent Name: _________________________________________________

Signature: ___________________________________________

Mailing Address: ___________________________________________

City, State, Zip Code: ___________________________________________

Telephone Number: _____________________ Date: _______________________

Email: _________________________________________________________

Submit completed form to: Bond Administrator

Charlotte-Mecklenburg Government Center, Engineering and Property Management, Land Development Division

600 East Fourth Street, Charlotte, North Carolina 28202-2844

Telephone: (704) 432-0960 Fax: (704) 336-6586

7/1/2013