HomeMy WebLinkAboutHO200900059 Application 2017-06-30Application for
Nome Occupation Class A Permit
Home Occupation Class A Permit = $13.00
Name of Business:
Tax map and parcel: OW 10 DO 013 O Magisterial District:
Physical Street Address (if assigned): v i So 1e rn0,n K A [�N
Location of property (landmarks, intersections, or other):
Zoning: PP— D
Contact Person (Who should we call/write concerning this project?): eel
Address I ci�i Sc��p,r,,��� i� City C��esv►1� State� lt Zip Z-gel
Daytime Phone (q3q) Igg 7g0(o Fax # ( E-mail
Owner of Record
Address ;na---_ City
Daytime Phone L_) Fax # C__)
Applicant (Who is the Coniact'person representing?).
Address Ste^ r
Daytime Phone
Fax # (___)
City
E-mail
E-mail
State Zip
State _ Zip
FOR OFFICE USE ONLY HO #
Fee Amount $/ ✓< 06 Date Pai y who? G Receipt # Ck# 1fJCP1 $y Gf�
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
2/11/2009 Page I oft