HomeMy WebLinkAboutLOD200600027 Application 2014-03-21;A,pplication for
Parcel of Record Determination and or Development.
Rights Determination
❑ Parcel of Record = $75
development Rights = $40
Project Name: A s i 5 r Y D NO Fft'ry F�" ?ac, p
Tax map and parcel(s): -rW i I l� - ;' Magisterial District: 5Cv TTSUI` UE Zoning: R A
Contact Person (Who should we call/write concerning this project?):
Address ft r-- , 1 City 5C0i1_S V i U6 State A Zip L G'
Daytime Phone( / Fax# L__) E-mail
Owner of Record IS +ttk•� 1%S 48 oy- / j
Address City State __._..� Zip
Daytime Phone C Fax # (_, E-mail
Applicant (Who is the Contact person representing?):
Address City State Zip
Daytime Phone C___,) Fax # ( 1 E-mail
Submittal Requirements
1. Tax Map Page
2. Last Instrument of record in the Clerk's Office of the Circuit Court of Albemarle County, Virginia oil or prior to
December 10, 1980 that includes a plat or metes and bounds description of the property. (Highlight or underline
references to the subject property).
3. All plats and deeds of record after December 10, 1980, UP UNTIL THE PRESENT DATE. (Highlight or underline
references to the subject property).
4. Any other pertinent information.
5. Cover letter stating the assumed number of parcels and development rights, with explanation of same.
A fee is required for each separate parcel shown on the tax map.
1 4 4 ^
ignature of O r
t Name
Date
Daytime phone number of Signatory
FOR OFFICE USE00 Date
qj / L/O�DJ# /�erK_(ALJV "vim I / )
Fee Amount $ b 0 •00 Date Paid - b J _ �By who?' " , f � i mf-" Receipt #6 IF/3 Ck# C#"fh By: W
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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