HomeMy WebLinkAboutHO200500094 Application 2017-07-24i• Lh.IIjI1� rr s D 4 P
Application for Home Occupation Class A Permit
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'`l Home Occupation Class A Permit = $13.00
Project Name: fir l
Tax map and parcel:0 q'G6 --Qd_ _�y�, W"D 1106 Magisterial District:
Physical Street Address (if assigned): _�(o �S 0 1 Y�_ (-i _
Location of property (landmarks, intersections, or other): 11 nu_(A_...
Zoning:
PC�D
Does the owner of this property own (or have any ownership interest in) any abutting property? If yes, please list those tax map and parcel numbers
Contact Person (Who should we call/write concerning this project?):
Address 5 Q 1L[ e Ci C, O State_ Zipn
Daytime Phone () J s� Fax # --E-mail C)
owner of Record — Sa�V►�+'c, —
Address
Daytime Phone ( )
City
Fax # E-mail
Applicant (Who is the Contact person representing?): 3
Address
City
Daytime Phone (_) Fax # E-mail
State Zip
State Zip
OFFICE USE ONLY �`/�
Fee amount 3 iDate Pai ck #J29By Who? Reccipt #'� SBy:
Uaunty otAlbemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
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