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LOD200500032 Legacy Document 2014-03-21
Request for, Parcel of Record Determination and or Development Tax map and parcel(s): C4— Iq is Determination Parcel of Record = $75 ❑ Development Rights = $40 Zoning: Acreage total: C - 3 Acreage for each parcel: �, 3•� % 1 0- Number of parcels: _5 ,,// Location of property (landmarks, intersections, or other): fn4 (es SOLI ✓fik v� (� Owner of Record atd 3 IFG Gwn Address 2g -2C7 (\i,,*,r �AnCity I`! JA State A Zip9_2 C_(24 Daytime Phone 341) ;Z•3 7-5-S-4- Fax # E-mail ®!—�'t f'►�U''► lu aq�(qrs' C evv Applicant (Who is the Contact person representing?): Pao 1 &A 1i !Iyen 6sr, ✓% c4 V'7•�s' xc" Address City State Zip Daytime Phone L__) Fax # n E-mail Contact Person (Who should we call/write concerning this project?): OWL _ �W f A (,S ce)r_ r►• ]�C1-�� Address City Daytime Phone ( "I) 1(p0 9(0 0 0 Fax #N3q T% mail Submittal Requirements State Zip Tax Map Page 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. ee is required for each separate parcel shown on the tax map. r- (0 21n�w_z 1 -�-( ©r Signa a of Owner or Authorized Agent Date OFFICE USE ONLY n 5 P3 U/ , �,� File Number Fee waived? YES / NO Fee amount $ /V Date Paid heck # � Rece� t #. �� (Q% �:�f���/jj,��,�----- r,.• a rv.:r�'L " tiger; County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4 -2,„ em19 3/24/05 Page1 of 1