HomeMy WebLinkAboutACSA199500003 Application 1995-01-26 APPLICATION TO AMEND THE 1---,c....%_d.oc" it County of Albemarle RECEIVED
h�:"III „'-p Department of Planning and Community Development
SERVICE AUTHORITY ° ®_VI 401 McIntire Road 1 2 61995
rVCharlottesville,VA 22902-4596
JURISDICTIONAL AREAS P 1,,,G,, � 804 296-5823 •
P!anr.!ng Dept.
APPLICANT Name: EL;/ eo.5,2e / /7S_e ii .0 Gat ( fr%X;s o //A
Signature: Phone: 9 -6-- ?7S 3
Address: �0 y/ /3n T// XV
r /`lure s ai//B/ U/a : c„2,?/I/
CO-APPLICANT Name (or agent, if any): /s/le v ✓1"aliri.? -Se
Signature: 4,,69-knzi'
2
%
Phone: 9f ' 25:3Address:
��� �cr Yc `LtGI C./bes • /e j 14. n?, 9'4
JURISDICTIONAL AREA DESIGNATION REQUESTED:
Water and Sewer ❑ Water Only
❑ Water Only to Existing Structure(s) 0 Limited Service (Describe in Justification
/ below)
7-)6'' i/lied'• '0� i �1�o ih, ¢ _ )1/4, e F1 S
PROPERTY LOCATION (Address) ,P4211Hte L� I l ��sf 016/l.29 Bw�l l en 1 of
Tax Map(s)/Parcel Number(s): .S-ie e l-_'ci 4 rc e/ _30
CURRENT SERVICE AREA DESIGNATION (If any):
❑ Water and Sewer 0 Water Only •
0 Water Only to Existing Structures 0 Limited Service
JUSTIFICATION FOR REQUEST: X 7 /rec.7 %v % ,, . Da ,,d <,c'sl,S/ a bow f c,'24 f e47 V4
lot/;t4 C aive SPWEr since ?LJ e F.i•et Ai s t ", e •0.4.4 1_..`ri'i, So C/O.S ea""e f'a Ghst*"44
M hd& / '"1c 4pJa7 c'4k b�ii/Lfiv4, LU,' LC1s /_7Pc7 c/kJ. /alI- pi-. /,,i./y /5n,:f /' g/
/arve an So' ,-- inT" I'i) 7Ler sJ �e ,e �oLi /�OPfri0 flit �A5. Ale J tie Jkwh Ted / e lU4 y
`dp,,,e, deli /.S rib pk Ak.... ale ahe t:ak-1-e/1/Jy IfSih4 y a--pr/44--,5 DL2 a ,z/ a- Privy. We- i i/d 00
1 57 r-/ oar resfrcein piE j•ec-T cl.S Jeon Ian/,-+s_s 7e, /ut.L,,AS !/vd 74r /Dill, cdnJi!/e'4z/ovf.
For Staff Use Only
DATE SUBMITTED: /- v�4 9.5 DATE$130 FEE PAID:A &t teyleG� --
// .
PROPERTY IS LOCATED (Check Appropriate):
❑ Inside or 0 Outside a Growth Area? 0 Adjacent to SAJA?
❑ Inside or 0 Outside a Water-Supply Watershed? 0 Adjacent to a Growth Area?
Location and distance of water/sewer line proposed to provide service
REQUEST FOR AMENDMENT ADOPTED: 0 Yes 0 No Date of Action