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HO200500102 Application 2017-07-24
Application for Home Occupation Class A Permit ❑ Home Occupation Class A Permit = $13.00 Project Nam Tax map and parcel: .00 00 _ jp A Q Magisterial District: �M Zoning: Physical Street Address (if assigned): .215� ( Cr-g = �' © '3+0re_ i 'r_, Ck�_ Location of property (landmarks, intersections, or other): 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?): _. Qey) �{ i to Lrz,� M o rri Address 2-55Cr-a; - sfI.Jp� p �[ Ciry ' o� _Stale _ Zip 2212-0 Daytime Phone qr, — S4% Fax # E-mail y0, Do 60r„t vner of Record Address r �� 4L �A Zip 2_�Q5 City •C (SU State Daytime Phone (:)`'16) '-( — 030 Fax # E-mail R�Applicant (Who is the Contact person representing?); L Address City Daytime Phone ( ) Fax # E-mail State Zip OFFICE US O L J �% Fee amount ate Paid Q{� By Who? eipt #<(' County of Albemarle Department of Community Development 401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 7/I/04 Page I of 2