HomeMy WebLinkAboutHO200500183 Application 2017-07-25OFFICE USE ONLY
HO# r Y V� �1rxt' � C�o -� �-� t-- - lJ
Application for Home Occupation Class A Permit
❑ Home Occupation Class A Permit = $13.00
Project Narne: "/ / ' rl/ aa y. -`"' l - J---V v' G
Tax map and parcel:—c6r7Magisterial District:.�"" `•it 1(&-/-Zoning: 1� ►`'
Physical Street Address (if assigned):1'" . 'i" � � o" y/ .4-w.+--
Location of property (landmarks, intersections, or other): 0 1/r
Does the owner of this property own (or have any ownership interest in) any abutting
Contact Person (Who should we call/write concerning this project?): G"
1
Address-Yr�tc7U� ` �G - City
Daytime Phone / ��� TO 5Fax #
Owner of Record
Address
Daytime Phone (___J
Applicant (Who is the Contact person representing?):
If yes, please list those tax map and parcel numbers
Imo% L A,4 cl
tAZip —2,
E-mail
City State -
Fax # E-mail
f i A art 4rol.4,1 �-
Address _ City
4, 4#&�,A�
Daytime Phone
E-mail
Zip
State Zip
OFFICE US"1 . /� S
Fee amount S ��_ Date Paid heEcl�"-- k By Who? VVLQ Receipt #1 L30 By
County of Aloemarie Deparinnent ox i-ommumty Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
7/l/04 Page 1 of 2