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LOD200500028 Legacy Document 2014-03-13 (2)
Request for Parcel of Record Development RiN - 0_0 Determination and or lits Determination ❑ Parcel of Record = $75 ;Development Rights = $40 .W O'W00-00-00 —00700 Tax map and parcel(s): O'W O d oo -- & o -- © G d 190 Zoning: 0'4!00 -00 -,.Co -- ©a8G0 oof o o — o o . 00 aog `� Acreage for each parcel: �I' a • �- 3� 44 Acreage total: SIFT Number of parcels: Location of property (landmarks, intersections, or other): 0,--, BroL v S 6—A -P 1 tNv,_.l k4-- t Owner of Record W t I � tn& w_, & t L_- u_c r a i Address —7 3 O I P r l Vt Sim- C_&. City State NC Zip � � S/ (0 Daytime Phone 9 & () v 9 / O Fax # l E-mail t5)CeP h c_b i k1 ` t Applicant (Who is the Contact person representing?): 1"1 � � \ t �`+{ � 0 t c - v c4- f - Address "0 Vt-) City State Zip Daytime Phone (_) Fax # E-mail Contact Person (Who should we call/write concerning this project?): W 6 lot �G `'N Address (5gr%. J--,--4 City State Zip Daytime Phone (_) Fax # 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 on 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. G. A fee is required for each separate parcel shown on the tax map. Cf Z c., Q� Signature of Owner or Autho zed Agent Date 3�7 2 J �-� V '� a� Q 0.6- (5 3,3_.1;T1 X 0 3 OFFICE USE ONLY %r �j,�l��% �j� /� �q /� File Number Fee waived? YES / NO Fee amount $ Date Paid �= check # 1 iG _.-, ecei - t - County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 97r2J,eW 72005 ''33/24/05 Page 1 of 1 COMMUNI-P( DEVELOPMENT