HomeMy WebLinkAboutHO200500099 Application 2017-07-24INrr 1L1. 1y_$4 R0L�1 F
Application for Home Occupation Class A Permit ob
Home Occupation Crass A Permit = $13.00
Project Name:
Tax map and parcel: QS�A M— ` 00 — 3500 Magisterial District:
Physical Street Address (if assigned): O 7 / U
Location of property (landmarks, intersections, or other):
Rt'!l Dr
Zoning:
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 _(Whoshould we call/write concerning this project?):_y.ixc
Address 9q_+0 ISOMrffiil
�Y� City __ _ /� State V14 Zip '::c/a0
Daytime Phone (SL&) q S ((, _ (do `JE Faaxv # 1% Ej-mail '� UM • C ni
Owner of Record _ (_a1� � L_/t�%7nk-r-L/r . z0_0/i
Address _ _Sa Y)�e City
Daytime Phone O
Applicant (Who is the Contact person representing?):
Fax #
Address _ City
Daytime Phone (_)
Fax #
E-mail
E-mail
State Zip
State Zip^
OFFICE USE ONLY j� / �y) Fee amounts j1.D 6 Date Paid Q�Chcck # �}s;By Who? f��l�I `t'- l�"M Receipt v S� By:
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
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