HomeMy WebLinkAboutSUB202200083 Application 2022-04-26sill :I1r'A0
APPLICATION FOR BOUNDARY LINE ADJUSTMENT PLAT
Boundary Line Adjustment = $246.48
$237 + $9.48 Technology surcharge
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Owner of Record
Street Address
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City
Phone Number
State
Zip Code
Email
Contact (who should we contact about this project):&AE
Street Address Aiffzt
City
Phone Number
State
"Zip Code
Email
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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APPLICATION FOR BOUNDARY LINE ADJUSTMENT PLAT
Owner/Applicant Must Read and Sign
The plat application process includes providing the County with all the information required in Chapter 14
Subdivision o. 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
application being provided to me or my designated contact via fax and or email. This consent does not preclude
such written communication from also being sent via first class mail.
Signature of Own e ontract Purchaser, Agent
Print Name
Sec. 14-208.1 Boundary line adjustments.
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Date
,43 4-
Daytime phone number of Signatory
The following sections shall apply to each boundary line adjustment, when applicable:
A. General: Sections 14-100 through 14-108.
FOR OFFICE USE ONLY SUB # Fee Amount $ Date Paid
By who? Receipt # C" By.
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