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Hoff TMP
Applicaflon for Home Occupation Class A Permit 9.1
�ome Owapation Class A Fermuit = SM00
Project
Tax map and parcel:
Physical Street: Addren (if assigned):
Location of pra" (landmarks, intersections, or other):
M2&tWJA1 District: zoning:
Does the Wow vfthis PrapeM virn (or have vrrgMMP intOrest in) IVY abutking prvpeM? If yes, please list tb,ose tax trap an3 psrcal )kutbbec4.- -
Contact Person (who sixv id -, caw - is comwRiew this F *cr.2y
Address o City a al v State V4 zip Z 29 1)
Daytime Phone (9ft ? 9 Fax { -to 2y Z
Owner of Xeeord A cNl �- � a-'%
Addms.AO3 .. iJ .Pcaj city to e5vi l Ve Store lk zip ZZ-1 f 1
Daytime Phone (L3!L} 913 -yl ri Fax # E-mail
Applicant (win is the Conwt person
Address b �00. city 10AAC5 Ui I �e State l!!!a - zip 227 ) f
Daytim Phme j�-I Lcil �-
D1f1�
3 ._....._— Fax #
0MCR Uimpaid
Fee a+[iaM S Check # �Y
t t7—gA.
County of Albemarle Department of Comm ity Develop ent
401 Mclutire Road Charlottesville' A 27.902 Vojce: (434) 296 M2 Fax: (434) 972-4126
T-a 711104 Page i of2
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