HomeMy WebLinkAboutACE200800001 Application 2006-10-28Application for_��
the Acquisition of Conservation Easements (ACE)
Contact Person (Who should we call/write concerning this project ?):
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Address I5:R Q Z I G A L Fj4kM City �5m-fT S L11(- L, t- State V 13 Zip Q ,�
Daytime Phone (���+� Fax # %_)
Owner of Record 14N+t c Ib /�)
- - E -mail
Entity Owning Property (sole owner, partnership, corporation, limited liability company etc.)
Address - p & -E, A S 0, �fj V t, _ City
Daytime Phone L_)
Fax # (�
E-mail
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State Zip
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Tax map and parcel(s): 13f; 000000n 1r7 A Q7 135 01 p DO100-oa DQ1, ii 35QTY11Y0On[y goo - yd ,0 %0QCS i C-) .7-1
Physical Street Address (if assigned): Q
Location of property (landmarks, intersections, or other):...C_ 07£,�st�164) OF TAr1'�3 f1 � VEX— R 04.0 Q0 �.
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Principle uses of property (grazing, timber harvesting, crops, livestock, recreation etc.): ; 1' 3 C. 0Q Ir} I-C 5—
Other Owners of Record:
Name:
Address:
Name:
Address:
Name:
Address:
Name:
Address:
Do you own other land in Albemarle County? ❑ YES NO Is it contiguous to this parcel? ❑ YES ❑ NO
Is property in an existing "Agricultural- Forestal" district? 0 YES ❑ NO
Do you have a Forest Stewardship Management Plan? ❑ YES ["NO If YES, provide date of plan
Do you have a Soil Conservation and Water Quality Plan? ❑ YES 2'�NO If YES, provide date of plan
Is the parcel definition of land identified on this application form threatened with a "forced sale" (see denition below)
F-1 YES HNO If YES, complete "Questionnaire" at end of this application.
Is the parcel land identified on this application form threatened with other "hardship" (see definition below)
F-1 YES NO If yes, complete "Questionnaire" at end of this application.
The parcel of land identified on this application form is a "working family farm, including forestry, and at least
one family member's principal occupation and income (more than half) is farming or harvesting timber from the
parcel"
❑ YES ENO
OR "at least one family member produces farm products derived from the parcel ".
❑ YES ENO If yes to either question, complete "Questionnaire" at end of this application.
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296 -5832 Fax: (434) 972 -4126
VAA ��7
List all Deeds of Trust, mortgages and liens against property (by date, parties involved and deed book reference &
page number):
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Is the propert subject to any other pending liens, judgments, zoning violations or court proceedings?
❑ YES �NO If yes, describe (by date, parties involved, legal reference or case number):
If you wish to include additional restrictions in the Deed of Easement (beyond those described in the sample),
please describe and enumerate them:
In addition, please provide the following information with this application:
a) Tax returns, for all owners of record, for each of the past three (3) tax years so as to verify adjusted gross income. All
income and tax information will remain confidential.
b) A completed "Application for Parcel of Record Determination and or Development Rights Determination ".
Definitions Contained in Questionnaire
"Forced sale" means the sale of a parcel with unused development rights in a manner prescribed by law conducted under
a judgment, order or court supervision, other than a sale arising from a partition action; a sale resulting from the
foreclosure under the laws of the Commonwealth of Virginia; or a sale that is not the voluntary act of the owner but is
compelled in order to satisfy a debt evidenced by mortgage, judgment or tax lien.
"Hardship" means an economic hardship, other than a circumstance causing a forced sale, experienced by the landowner
of the parcel compelling him to place a parcel with unused development rights for sale or to use such development rights.
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Owner /Applicant Must Read and Sign
I/We hereby make application to the County of Albemarle for the sale of development rights on the tax parcel(s) identified
above on this application form pursuant to Albemarle County Ordinance No. 00 -A.1 (1), the Acquisition of Conservation
Easements. I We understand and acknowledge that Uwe incur no obligation by completing this application, and that the
County of Albemarle incurs no obligation by its acceptance of this application. I/We hereby certify that, to the best of our
knowledge, the information contained in this application and attached materials is true and correct. I/We agree grant
permission to the ACE Program Administrator or his designee to enter the property, after reasonable notice to the owner, for
the purposes of evaluating the parcel(s) and verifying required information on the application form and the independent
appraiser who must appraise the property to determine the value of the development rights.
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S' ,ature of Owner Date
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Print Name
Signature ,-9W
er � Date
G)' r .a -AA)1 ;L.
Print Name
Signature of Owner
Print Name
Date
Questionnaire for Ranking Criteria in ACE Program Eligibility Criteria
1. The parcel land identified on this application form is threatened with a "forced sale" (see attached definition).
❑ YES L NO If yes, describe and/or document:
2. The parcel oriand identified on this application form is threatened with other "hardship" (see attached definition).
❑ YES [g 'NO If yes, describe and/or document:
3. The parcel of land identified on this application form is either: "a working family farm, including forestry, and at least one family
member's principal occupation and income (more than half) is farming or foresting the parcel
❑ YES 0 NO
OR; "at least o e family member produces farm products derived from the parcel ".
❑ YES Z NO If yes to either question, describe the type of farming (including horticulture) or forestry you engage in.
I/We hereby c }coat, to the best of our knowledge, the information provided on this questionnaire is true and correct.
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62/andow- Date
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I andovcm Date
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