HomeMy WebLinkAboutLOD200700032 Application 2014-03-20 (2)Application for,oFA�
Parcel of Record Determination and or Development, 9
Project Name:
Tax map and parcel(s):
is Determination
❑ Parcel -Record = $75
evelopment Rights = $40
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Magisterial District: "%1'!l�/�— Zoning:
Contact Person (Who should we call/write concerning this
tprroj�e�ct?): � r'
Address b � 1 jJ r ""°' L Ci
Daytime Phone (_� Fax #
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O f Record F'J 0 i
city
State Zip
E-mail
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Daytime Phone (o .�3 %/v 9 , Fax
Applicant (Who is the Contact person representing?):_ V �� ,Z2-0
Address �t� � `� cf city 00-, "t lmY+`""�State _Zip
Daytime Phone (^ 92 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 eds of record after December 10, 1980, UP UNTIL THE PRESENT DATE. (Highlight or underline
references to subject property).
4. Any other pertl t information.
5. Cover letter stati the assumed number of parcels and development rights, with explanation of same.
A fee is required fo each separate parcel shown on the tax map.
Signature of Ownei
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Prin Name
FOR OFFICE USE ONLY
LOD #
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Date
3 ~ 's a)- (t�4 �
Daytime phone number of Signatory
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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