HomeMy WebLinkAboutLOD200900008 Application 2010-03-01Application for
Parcel of Record Determination and or Development
Ri
Project Name: J C^j / ` r/ S
is Determination
(� Parcel of Record = $75
Development Rights= $40
Tax map and parcel(s): '7 '" q (n Magisterial District:
Contact Person (Who should we call/write concerning this project?):
Ci,1koL JisNn/iN65
Zoning:
Address ^i Jam) R L XL L R
City
State P&OL
Zip
/r
Daytime Phone ( 7 'J 1o) `f goy ? Fix U)3 ��� -�' 4 �1 a E-mail G�t���'/�
,�
�i S ��Li i�3�
� Goat a33
Owner of Record
Address ��' 2- SG ao) ,� `
City 4A �i AJ A- r--
State ry
Zip Zl'-�-z-
Daytime Phone 6O q 9i - 9 ° Y2 Fax #
E-mail
Applicant (Who is the Contact person representing?): �i 4}., �ti. S�L-
a,I.Q pt'g5pr A RW
• ®,f + "'L ��}�
/
Address i� )i P, L K e RD
City
State
Zip -2-1
Daytime Phone (_) Fax �a � �tJ4� L�
E-mail C "�J✓.r ®� lj,�
(� rAvt�dcl�- N ��'--
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 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.
l�wQ 7 -
Signature of O Date
- 2 7
Print Name Daytime phone number of Signatory
------------------------
FOR OFFICE USE ONLY LOD #
C15 - pg B J
Fee Amount $ ��� 0 Date Paid/ By who? D / / S Receipt #- V 1 Ck# Y
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 1 of 1