HomeMy WebLinkAboutLOD200500023 Legacy Document 2014-03-20 (2)"Request for
Parcel of Record Determination and or
DeveloDment Ri
Tax map and parcel(s): (�5 ✓ tt A
Acreage total: Z3-31 J
Number of parcels: z
is Determination
Parcel of Record = $75
Development Rights = $40
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Zoning: IM
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Acreage for each parcel: VW -5,60 1z6- 6353
Location of property (landmarks, intersections, or other): 51ZJ� l"i ��1 �'^ 9`M (cab
Owner of Record
Address
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City
State Zip
Daytime Phone ( ) Fax # E-mail
Applicant (Who is the Contact person representing?): & L � Nun
Address City State p
C `0 ( �-7 , 4.5WI6 V P 1° zi
Daytime Phone ( ) 7(-; 1� _735b Fax # E-mail
Contact Person (Who should we call/write concerning this project?): W w V _0' G40—<V1
Address C (,� d Iy llcdh-� ?zao City 00 State d 1' Zip�Z�a�.
Daytime Phone ( ) -G`065 Fax # 1 if `SLZU E-mail d® fov&Q IUB'►- i-,
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
4.
5.
references to the subject property).
Any other pertinent information.
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.
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Signature of Owner orut orized ent
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Date
-OFFICE-USE-ONbY
Number
__ _ _ _ _ ��
YES /NO Fee $ l J [�Date
_ _ L I
Paid ��Check # �1
Receipt #6_461.9
File
Fee waived? amount
County of Albemarle Department o ommumty Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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