HomeMy WebLinkAboutLOD201800010 Application 2018-07-20FOR OFFICE USE ONLY LOV #
Fee Amount SDate Paid'"", ,ho? eceipt `--Ck�, By:
�'J . 4f a,,
Application for
Official Letter of Determination
0
❑ Official Letter of Determination of Parcel of Record and/or Development Rights = $108
❑ All other Official Letters of Determinations (including but not limited to Use, Zoning, Nonconformity, Parking,
Floodplain, Vested Rights, Area & Bulk Regulations, De minimis) = $108
/]Certification that notice of this application has been provided to the property owner, if owner is different from applicant.
Project Name: ` ' l
Tax map and pareel(s):
Contact Person (Who should qwe call/write concerning this project?): e-
Address �JJ /�'' / L''77-® (��,(`nL lx U City State Zip��
Daytime Phone (j3� k_73 - j'/ 6 1 Fax #
Owner of Record
Address %� /aY`3�t0 f� (�`�Pd - v v City >� rl State Zip2_.2&L
Daytime Phoney t) / �7 Fax # (_) E-mail 1(►1 ��P i1�1Y71?�� l ) Q.
Applicant (Who is the Contact person representing'?): V�
Address
Daytime Phone�L3q q't& -9g6bFax ✓a( )
Parcel of Record and/or Development Rights
❑ Tax Map Page
City
❑ Last Instrument of record in the Clerk's Office of the Circuit Court
of Albemarle County, Virginia on or prior to December 10, 1980
that includes a plat or metes and bounds description of the property
(Highlight or underline references to the subject property).
❑ All plats and deeds of record after December 10, 1980, UP UNTIL
THE PRESENT DATE. (Highlight or underline references to the
subject property).
❑ Any other pertinent information.
❑ Cover letter stating the assumed number of parcels and
development rights, with explanation of same.
State Zip
E-mail
All other Determinations
❑ Cover letter stating what is being requested. Provide all
necessary information for the consideration of this
decision including
❑ Tax Map Page if request is regarding a specific
property.
❑ If the request is regarding a nonconforming use,
structure, or lot then you must provide enough
probative material evidence to prove the
nonconformity.
❑ Provide justification for the request and any
other pertinent information.
ElA fee is required for each separate parcel shown on the tax map. I
El Fee as noted above.
Please refer to the Albemarle County Land Use Law Handbook for more information
n regarding zoning determinations and nonconformities. httn://ww�e.albemaric.org/LandCseL,a��
Signature of Owner
Print Name
Date
Daytime phone number of Signatory
Count` of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126
IL] 'l /2015 Page I of']