HomeMy WebLinkAboutLOD201800016 Application 2018-10-08FOR OFFICE USE ONLY LOD # � r
Fee Amount $ Date Paid lok/lxy who? C Receipt1�'# • ` By:
Application for
Official Letter of Determination
IQ Official Letter of Determination of Parcel of Record and/or Development Rights = $108
A separate fee is required for each parcel shown on the tax map. (1 parcel is $108, 2 parcels are $216, etc.)
❑ All other Official Letters of Determinations (including but not limited to Use, Zoning, Nonconformity, Parking,
Floodplain, Vested Rights, Area & Bulk Regulations, De minimis) = $108
❑Certification that notice of this application has been provided to the property owner if the owner is different from applicant.
Project Name: I M t-a c, L h Tax map and parcel(s): J -3 3 Zoning: Ruca 1 Ac-e.a5
Contact Person (Who should we call/write concerning this project?): J& �, r 3 a
Address �T_City C6r-11�'i-- SUt! 4State Zip Z2190
Daytime Phone (� g.�- 16 / G Fax # (—)
E-mail �J h �a �S r 0 yam.
Owner of Record J p L . k! m43
Address 11 L Uw4jt+st ��62 City��SVIW �C State V j4=_ Zip 7:3 O
Daytime Phone l f, 11 $02 S / iv I S� Fax # ( )
Applicant (Who is the Contact person representing?):
Address
Daytime Phone (_)
Fax #
E-mail �%�csco�t2f�� • C'Cn„'
City
E-mail
Fee Receiver]
4 ( (-)S,Co
Received Date
N/41 (�g
Received By
'�'V�
State Zip
DECEIVED
OCT D 4 1018
COMMUNITY
DEVELOPMENT
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
9/7/2018 Page 1 of 2