HomeMy WebLinkAboutSUB202300001 Application 2023-01-030191: IIr•/•
APPLICATION FOR BOUNDARY LINE ADJUSTMENT PLAT
Boundary Line Adjustment = $2-t5 a q-(,, 48
(Provide 5 copies of plat)
Project Name ?zrr./ sC CU. 4,i A c.
Tax map and parcels T M I P. z LT> 5 2G
- A
Physical Street Address (if assigned):
Applicant An✓A. c4fz-q�
Street Address
-
City ' v I( e State V 2
Phone Number 'i` L{• Z q'2,• % S ih
Zip Code 2..2 5 n Z
Email ✓
Owner ofRecord—AA.e,2r2 H�2- IL:
Street Address
City e lc (.. state �z
Phone Number
Zip Code 2 2 c, - Ce
Email
Contact (who should we contact about this project): Arl 64
Street Address
,�/'�
�
City State
Phone Number
Zip Code
Email
County of Albemarle
Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
C
L]
APPLICATION FOR BOUNDARY LINE ADJUSTMENT PLAT
Owner/Applicant Mast 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. 1 have read and understand the
provisions of Chapter 14 Subdivision of Land of the Albemarle County Code.
By signing this application 1 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 o gwrier, Contract Purchaser, Agent
�d
Print Name
Date
/r3--. 2G3 7 5-10
Daytime phone number of Signatory
FOR OFFICE USE ONLY SUB d Fee Amoaat S Date Paid
By who? Receipt M Ckv By:
/1/2015
or, ED
DEC 3 0 1011
COMMUNITY
OEVELOPMENT