HomeMy WebLinkAboutLOD200600007 Legacy Document 2014-03-20 (2)w t;outrry 01 A►uemarie uepartment of Community Development
Ol M Intire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
3/24/05 Page 1 of 1
Request for J'
Parcel of Record Determination and or4�'Im,L
Development Rights Determination
❑ Parcel of Record = $75
Development Rights= $40
Tax map and !Z5 �� l ZS ` / Zoning:
parcel(s): . .
Acreage total: Acreage for each parcel:
Number of parcels:
Location of property (landmarks, intersections, or other): ` L 7-6 40 Raa� /L
Owner of Record 6h2 AZ 6;FX
Address City State Zip
Daytime Phone (__J Fax# E-mail
Applicant (Who is the Contact person representing?):
Address 1,2 C%� /��G'�/��( C( fL� 4;r city (a t72�72,l49tate Zip,?a 01
Daytime Phone E-mail .
Contact Person (Who should we call/write concerning this project?):y
Address C� %O ��/'� �� �� �� AC l City U�State 1%� Zip 2 -
Daytime
Daytime Phone 6Ff` : Fax # -0a IF E-mail dZ
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.
h
2,59 a
Signature of Owner or Authorized Agent 'Date
--OFFICE USE-ONL-Y
File Number Fee YES / NO Fee $ Date Paid Receipt #,
waived? amount
Ltc�
w t;outrry 01 A►uemarie uepartment of Community Development
Ol M Intire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
3/24/05 Page 1 of 1