HomeMy WebLinkAboutLOD200800003 Application 2014-03-17 (2)Application for
Parcel of Record Determination and or Development ^�
RiLyhts Determination
❑ Parcel of Record = $75
YDevelopment Rights = $40
Project Name: jj rr�� �p
Tax map and parcel(s): `- 0 �/ 9 -ab Magisterial District: �� �U IU>4 Zoning: I�UC-
Contact Person (who should we call/write concerning this project?): ��T�� C�L(G�T•1.5 r—��_ �—rn—
Address /�1M _P0 0', ►`t �D City BA of L F 1� 0 State �trc Zip
Daytime Phone ( 67 � �� t � Fax # � -t�S - �p'(�7 E-mail (Ue- a,- CSO ��j'-Z j e,+
Owner of Record Lvrn6 lb_
Address 'Cl U}J ( wL
City P_L�96iI,uipn , State VA Zip
Daytime Phone qjj Fax # �? S- �'7�%/ E-mail t 4UJ I) e— 0 C& '' (%( rY--4—
Applicant (Who is the Contact person representing?): j%irlS
Address City
Daytime Phone
Submittal Requirements
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.
Signature Af Owner Date
fCi,�- 2'73 5"9'/2
Print Name Daytime phone number of Signatory
FOR OFFICE USE /ONLY p� LODF#
Fee Amount $ �[ / Date Paid % t/ By who? V t Receipt #�Ck# V By:Au lw�
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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