HomeMy WebLinkAboutSUB202200018 Application 2022-02-11Project Name Lut C•
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Tax map and parcels -T- ./O 1 r 1" 1 ( T
Zoning -;� /-\
Physical Street Address (if assigned):
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Applicant
Street Address
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City C v' 11.-e,
State E/2
Zip Code
Phone Number 4 3 Z}-
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Email cp I 41p
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Owner of Record AvIl rn
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Street Address
City
State
Zip Code
Phone Number
Email
Contact (who should we contact about this project):
Street Address f W, j1 ; -) -
City
State
Zip Code
Phone Number
Email
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APPLICATION POLL A SU131DIVISION PLAT
Owner/Applicant Must Read and Sign
The plat application process includes providing the County with all the information required in Chapter 14
Subdivision of Land of the Albemarle County Code.
The foregoing information is complete and correct to the best of my knowledge. I have read and understand the
provisions of Chapter 14 Subdivision of Land of the Albemarle County Code.
By signing this application I am consenting to written comments, letters and or notifications regarding this
salication being provided to me or my ucdesignated
h written Communication from also iate contact
onta ticvia
s mailfax . d or email. This consent does not preclude
� Contract Purchaser, Agent
Signature of Owner,
Print Name
FOR OFFICE USE O LY SUB #
By who?
Receipt #
Date
Daytime phone number of Signatory
Amount
Paid
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