HomeMy WebLinkAboutLOD200800002 Application 2014-03-17 (2)Application foroFA�Fy9�
Parcel of Recom(_�etermination and or L"velopment ,
- y/xrlNh
Kints .Determination
Parcel of Record = $75
Development Rights = $40
Project Name: O (2cf , S r, lana`+ o w Or�C
c
Tax map and parcel(s): �GQ'®® "o�'o� 9 ®� Magisterial District: tzoning:
Contact Person (Whq should we call/write concerning this project?): Y�
Address �� ®°®iC� city
Daytime Phone (29v
9*7 -2 - l'l fP 2Fax # L--,
Owner of Record l �- ,-� ((QQyt
Address 5 ('d n P C9a.�. OA- �� CD k.A -- City
S U ► L --o `J
0"mtteU/it C- Zip e;;�%90Z
E-mail 10011els+U K. R_
r4e"1'
Daytime Phone C_) Fax # L) E-mail
Applicant (Who is the Contact person representing?):
Address City
Daytime Phone (_) Fax # C__) E-mail
Submittal Requirements CsQ.0TD
2
3
QN
State Zip
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).
All plats and deeds of record after December` 10, 1980, UP UNTIL THE PRESENT DATE. (Highlight or underline
references to the subject property).
Any other pertinent information
Cover letter stating the assumed number ofparcels and;development rights, with explanation of same.
r
fee is required for each separate PRI l shown on; the tax map.
Signature of Owner
FOR OFFICE USE ONLY I LOD #
Fee Amount
Date
r
Daytime p one number of Signatory
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 I of I