HomeMy WebLinkAboutLOD200700005 Application 2014-03-21 (2)Application for
Parcel of Record Determination and or Development " -
rrxa`
RiLyhts Determination
❑ Parcel of Record = $75
X Development Rights = $40
Project Name: iJAKS(Dn ko r¢.vi S &Vel-apm-eKfi De�Jkf'K p
Tax map and parcel(s): " !1 A Magisterial .District: S Seo�S K
✓;11&oning:
Contact Person (Who should we call/write concerning this project?): jw k h 67 r J km Z --,QP-, 5 t 44W to i2o ,p
Address 3 9 (p o In 4s, H e- c L•h City 6- k rl01•l+ syd i f State VA zip �Lo 3
Daytime Phone (q?q) q6" Fax # `I �• - 3 (I E-mail ► � f : k Z� (0 % 0. i,,J . Ld vK
Owner of Record rG yR To k Vt Seg n 2
Address 4J Q a l M 24 142 r, 1. -t City L ^S i e y State Zip 3
Daytime Phone(?I T) ���' " ?11 Fax # (_)
E-mail
Applicant (Who is the Contact person representing?): -e c. -.S & &c f & r_t On -4,o Lt. -
Address
Daytime Phone (__)
Submittal Reauirements
Fax # L_)
City
E-mail
State Zip
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.
A fee is required for each separate parcel shown on the tax map.
FOR OFFICE USE ONLY
Fee Amount $ Date"Paid '2• " " By
Date
jowbn 4 3� i g T 7- 966
Daytime phone number of Signatory
Receipt # Ck#.
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
5/1/06 Page 1 of I