HomeMy WebLinkAboutHO201000065 Legacy Document 2014-07-16Application for
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Home Occupation Class A Permit'
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❑ Home Occupation Class A Permit = $13.00
Name of Business: 1 ez+ 7_W ',P Fo,.'r ice"&c T V L1__(_,
Tax map and parcel: � r Magisterial District: �, �f�W-4-- Zoning:
Physical Street Address (if assigned): �,( C3fyda4esV'i t12, VA
Location of property (landmarks, intersections, or other): { V y Ad • el J (I Ln n,6J e, DR,
Contact Person (Who shouldwe call/write concerning this project?): i co_n,/ rk- e, I ! f
Address 15 761a N Vl at D A 4 - City Clijm rl c_A 'M I (,,State V A Zip t% 03
Daytime Phone O 7
Owner of Record
Address �. p
Daytime Phone (___)
Applicant (Who is the Contact person representing?):
Address
Daytime Phone
Fax # L_)
Fax # L_)
City �Y�CmI� State _ Zip
E-mail
City State Zip
E-mail
FOR OFFICE USE ONLY �j % HO0# U o
Fee Amount S �� --C70 Date Paid 7(V' By who?('tU"~1� t_Ce(`0 Receipt # Ck# 6By: U C5
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
2/11/2009 Page I of 2
Type of Business P i