HomeMy WebLinkAboutHS202000018 Approval - County 2020-03-19Homestay
Zoning Clearance
FOR OFFICE USE ONLY HS#
Fee Amt: $158
Receipt#: C—EJIOV
1. Applicant/Owner Information
APPROVED
Date�_ --F0'u1lC1ll
0- nz—z3 By:
Ck# FF77��
»�u Albemarle County
Community Development
T 401 McIntire Rd., North Wing
n S Charlottesville, VA 22902
ixcax�a� Phone 434.296.5832 1 Fax 434.972.4126
NAME: �OJ ll v� P r �ra✓Pn G G� �^c! U Get a rt �/�iOL �rv✓P r� u o
E-MAIL ADDRESS: /V2 d vL /1/C% Q .S PHONE: 1 2 1& 3� d /7/3
MAILING ADDRESS: %R9.3 Jay, �a/nf 2� CLtai�arfes�,/4Z ✓a ZZq//
2. Homestay Information
TAX MAP AND PARCEL NUMBER
(OR ADDRESS, IF UNKNOWN):
2W / - �a fj�J N� �' C
/�J y �� �I✓ !/CL ?Z5;
ZONING:
ACREAGE:
HOMESTAY NAME:
9% crcres
y���roa�
RESPONSIBLE AGENT NAME:
Cfl�'tlrl 4L SAME AS ABOVE (OWNER)
RESPONSIBLE AGENTEMAIL:
O
RESPONSIBLE AGENT PHONE:
21& 3%C> /7/3
RESPONSIBLEAGENT ADDRESS:
3. Verification of Requirements
NUMBER OF GUEST BEDROOMS:
USING ACCESSORY STRUCTURES?
2 FORMS PROOF OF RESIDENCY PROVIDED?
FLOOR PLAN SKETCH PROVIDED?
2
YES NO
YES NO
YES NO
PARKING REQUIRED:
TOTAL HOMESTAY USES ON PARCEL
Dwelling 2
Numberof Guest Rooms + Z
Total Off -Street Parking
4. Applicant Signature
I hereby apply for approval to conduct the homestay identified above, and certify that this address is my legal residence. I also certify that I have
read the restrictions on homestays, that I understand them, and that I will abide by them.
SIGNATURE OF OWNERiAPPLICANT:
DATE.
PRINT NAME:
DAYTIME PHONE NUMBER:
Can 1Gh ice/ Pn U rJ J-P -Nvrv6
Zilo
Approved Approved with Conditions [ ] Denied f I
ZoningOfficial: Date: -31 Mho
VDH Approval Date Building Official Approval Date: 0 ' ad Fire Marshal Approval Date: UI
Conditions
SUBMIT THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL (IF REQUIRED) , AND YOUR $158 APPLICATION
FEE TO COMMUNITY DEVELOPMENT, 401 MCINTIRE ROAD, CHARLOTTESVILLE, VA 22902
www.albemarte.org/homestays v. 9/17/191 Page 5 of 13
Matilda Beauford
From: Provencios <provencios@gmail.com>
Sent: Monday, March 2, 2020 5:18 PM
To: Matilda Beauford
Subject: Fwd: Homestay inspection 20-18
CAUTION: This message originated outside the County of Albemarle email system. DO NOT CLICK on links or open
attachments unless you are sure the content is safe.
Inspection approval.
Samantha
Sent from my iPhone
Begin forwarded message:
From: Michael Dellinger <mdellinger albemarle. rg>
Date: February 27, 2020 at 1:47:49 PM EST
To: Provencios <provenciosQgmail.com>
Cc: Rebecca Ragsdale <rragsdale@albemarle.org>, Keith Bradshaw <kbradshaw@albemarle org>, Shawn
Maddox <smaddox@albemarle.org>
Subject: Homestay inspection 20-18
This email is to confirm that your homestay inspection located at 1887 Stony Point Road passed
inspection today.
4
Regards,
l3"� (96ctuzz
'4Z> ' I�COU41ty, 144
401 1111clI n t�0-Roalcil
C c,wZOtteii1 ZZ, k1,4 22902
434 -296 -5832
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ALSEMOU OtARUXTESVUE . PLUU4 HA
GROW'016A PaSON
w.,TJHD.C= THOMAS JEFFERSON HEALTH DISTRICT
TRANSIENT LODGING REVIEW
Operating Name of Business:
fadiity Address: �� ` 3 cf y �a �." � �� �LrUr /u Jvr/!! ?z
Tax Map Number. 0 & .2 co - Q d — o eo A
Subdivision: Section: Lot:
Owner/Agent: �_ Co * t7X1L/U1L er►U o Home Phone: Z/61 3i d i 713
Address: l,�q 93 -lam y ,ram-/ Ceil Phone: ZA0 Div 213
Emall: /7/f
Will food be prepared for guests? n/0
Total number bedrooms in rental unit, guest + owner -occupied:
Water Source (check appropriate): Public Water System
Other (please specify):
Sewage Disposal (check appropriate): Public Sewer
Will the proposed lodging involve any new construction? Ne
If so, please specify:
a
Private Well "" "
Private Septic
Signature (owner or agent) Date: a I A q7
Page 1 of 2
Health Department Use
VDH PERMITTING REQUIRED: B&B Permit Hotel Permit veNone
SEWAGE DISPOSAL SYSTEM:
Adequate / Approved
A review of our records and/or assessment by a licensed professional, and all other
information available, has indicated that the existing sewage disposal system (SDS)
and reserve area (where indicated) appears to have been designed with adequate
capacity for the proposed use. This does not imply that the existing SDS will
continue to function properly for any period of time. A site visit and inspection
may not have been performed.
• Note: For optimum preventative care, septic tanks should be pumped out by a licensed
sewage hauler every 3 to 5 years.
Inadequate
A review of our records and/or assessment by a licensed professional, and all other
information available, has indicated that the existing sewage disposal system is not
adequate for the proposed use.
WATER SOURCE: �pproved Not Approved
• B&B (w/ food service): coliform bacteria & nitrate testing required
initially, then annually thereafter, prior to permit renewal.
• Transient lodging w/o food service: Annual coliform bacteria test required and
recommended annually thereafter.
COMMENTS: jrc..A i c. `f" cam(lg 9 cwt� `4'r ,fit �wo�c
Z- b
Health Department fficial
Page 2 of 2
Date