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FAMILY SUBDIVISION AFFIDAVIT
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COUNTY OF ALBEMARLE
AFFIDAVIT
Verifvin2 Family Relationship of Grantor to Grantee
I, LYNN R. RUBENOFF ,(property owner/Grantor)hereby certify that the subdivision of Tax Map
110 Parcel 15A is a family subdivision in accordance with Sections 14-208, 14-211,and 14-212 of the Albemarle
County Subdivision Ordinance,and that the table below outlines the relationship of each Grantee to the Grantor. I
acknowledge that I have read and understand Sections 14-208, 14-211,and 14-212 of the Albemarle County Subdivision
Ordinance which is attached to this affidavit.
Grantee(s) Relationship to grantor Parcel/Lot
SARAH RUBENOFF DAUGHTER PARCEL"Z"
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The foregoing instrument was acknowledged before me this .64day of r`\ Aac 1" ,20(i by
L-yNN .?`•\AUh'ti J-+ Grantor.
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Sec 14-106 Definitions
Family subdivision. The term"family subdivision" means the single division of property for the purpose
of sale or gift to a member of the immediate family of the owner of the property.
Member of the immediate family.The term "member of the immediate family" means the natural or le-
gally defined off-spring, grandchild, grandparent,or parent of the owner of property.
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COUNTY OF ALBEMARLE
Department of Community Development
401 McIntire Road,Room 227
Charlottesville,Virginia 22902-4596
Phone(434)296-5832
Date: May 17, 2017
John Blair
County Attorney's Office
401 McIntire Road
Charlottesville, VA 22902
Regarding:
Project Name: SUB201700045—Rubenoff Family Subdivision Date Submitted: 5-9-17
Dear Mr. Blair:
The applicant has prepared and submitted an Affidavit Verifying Family Relationship of Grantor to
Grantee,a Declaration of Restrictive Covenant,and a Private Street Maintenance Agreement for the
above named project. At your earliest convenience,please review these documents and the attached plat
for the division. Should you have any questions or comments please feel free to contact me.
Sincerely,
Christopher P. Perez, Senior Planner
County of Albemarle
Department of Community Development
401 McIntire Road
Charlottesville,VA 22902
cperez@albemarle.org
(434)296-5832,phone ex.3443