HomeMy WebLinkAboutLOD200700018 Application 2014-03-20 (2)Application for
Parcel of Record Determination and or Development�'1:
RiLyhts Determination
Parcel of Record = $75
Development Rights = $40
Project Name:
Tax map and parcel(s): Magisterial District: Zoning:
Contact Person (Who should we call/write concerning this project?): L l 5 Com. rQLr Gn � r
Address 3,PC1(e Dcc bis CrassiM City ChGVIoWEVl11-r- State V_Zip 22 q
Daytime Phone tl 3 `t 1 -170 Fax # Email !1 l ry- 1 s, qLc gi:> QO 1 - C D n'l
Owner of Record Fran r— 15 E , �Ci .r er
Address 19);1 O) d L11nch l b�,t �e,� r City C 0 o, do0 c5 ' ) � k state VA Zip —aca(�
Daytime Phone � a 96- y3 ll Fax # C__) E-mail
Applicant (Who is the Contact person representing?): CCLn C.15 i= . (_ Gd\1 f
Address 1 a i a D 1(� RA—city C' -h j 0Jk JJJC State ^ Zip QQ9D 3
Daytime Phone ag �n ^ l Fax # �� E-mail
Submittal Reauirements
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.
It
Signature of Owner Date
Print Name Daytime phone number of Signatory
FOR OFFICE USE ONLY LOD # r7C.UV
Fee Amotmt $4,_ Date Paid 6. who? T# (a rkJe.Iri Receipt # b l�C0 By:
County of Albemarle Department of Community Development
401 McIntire Road, Charlottesville, VA 22902 Voice: (434) 296-5832 Fag: (434) 972-4126
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