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HS201900022 Approval - County 2020-10-05
Albemarle County Homestay APPROVED401 41k� Community Development McIntire Rd., Nor[h Wing Zoning Clearance by me AlbemarleCOUnfyPhone Charlottesville,VA22902 434.296.58321Fax 434,972.4126 FOR OFFICE USE ONLY HstF+ Fee Amt: $158 Date PS Receipt #: I % /a�� Ck# 1 } V By: 1. Applicant/Owner Information NAME: �tAQl Tom. RS 0 E-MAILADDRESS: 'S 1 HONE: MAILINGADDRESS: lOt} �D✓ ^' ' N]) V ^ 2. Homestay Information TAX MAP AND PARCEL NUMBER (OR ADDRESS, IF JNKNOWNE ZONING IDA — I ACREAGE: TJ�CS-�"tJY/I IIC R�r HOMESTAY NAME: li4t-al l] RESPONSIBLE AGENT NAME: i�'ltO... ,;t,.._,_z SAMEASABOVE( NER) RESPONSIBLEAGENTEMAIL: RESPONSIBLEAGENTPHONE: ©t/ RESPONSIBLE AGENT ADDRESS: = 3. Verification of Requirements NUMBER OF GUEST BEDROOMS. USING ACCESSORY STRUCTURES? 2 FORMS PROOFOF RESIDENCY PROVIDED? FLOOR PLAN SKETCH PROVIDED? YES NO VES NO YES NO PARKING REQUIRED: TOTAL HOMESTAY USES ON PARCEL —� Dwelling 2 NumberolGce tRoams + t Total OH6treet Vanung 4. Applicant Signature I hereby apply for approval to conduct the homestay identified above, and certify that this address is my legal residence. 1 also certify that I have read the restrictions on homestays, that I understand them, and that I will abide by them. NER IfIll DATE: Z DAYTIME PHONE NUMBER: Approved Approved with Conditions I ] Denied I ] Zoning Official: Date: )� 5 A 0 VDH Approval Date: . �6uilding Official Approval Date: Fire Marshal Approval Date: Do'tU 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 VXA— Lair 15hz ,moos lrc Sco�44sVollc id I l ti FairrYoo of 3 ) L"e U1 PwivWooal (�) 6..na TK.I ( Sl) !'lain NoLt ►.L 104 F; ;rwood !,n Nov 18, 207g Customer Bill , Dominion DUANE S CASSIS 3625 SCOTTSVILLE RD � Energy® CHARLOTTESVLE,VA 22902 i-wase read the last page for Important Information about billing and account options available to you. Billing and Payment Summary Account # 4623972611 Due Date: Dec 11, 2019 Total Amount Due: $ 50.03 To avoid a Late Payment Charge of 1.5% please pay by Dec 11, 2019. Previous Amount Due: Payments as of Nov 18: 12.09 12.09CR For service emergencies and power outages please call 1-866-DOM-HELP (1-866-366-4357). Visit us at www.dominionenergy.com. Meter and Usage Current Billing Days: 30 Billable Usage Schedule 1 Total kWh Measured Usage Meter: 0260619848 Current Reading Previous Reading Total kWh Current Reading Demand Usage History Mo Yr kWh Nov 18 52 Dec 18 55 10116-11115 Jan 19 53 332 Feb 19 59 Mar 19 50 Apr 19 45 10116-11115 May 19 39 71952 Jun 19 38 71620 Jul 19 71 332 Aug 19 61 5.99 Sep 19 78 5.99 Oct 19 37 Nov 19 332 Important Customer Information from Dominion Energy Virginia Explanation of Bill Detail Customer Service 1.866-DOM-HELP (1-866-366-4357) Previous Balance Payment Received Balance Forward Residential Service (Schedule 1) Distribution Service Electricity Supply Svc (ESS) Generation Transmission Fuel Sales and Use Surcharge 12.09 12.09CR 0.00 10116-11115 14.58 16.51 6.54 7.72 0.18 IM State/Local Consumption Tax 0.50 ALBEMARLE Utility Tax 4.00 Total Current Charges 50.03 Total Account Balance 50.03 To better understand how your bill is calculated, visit www. dominionenergy. comlyourbill. Help a family in need through EnergyShare - add $1,2,5,10,20,25 or 35 to your payment. Overpayments in these exact amounts are automatically recognized as a contribution to EnergyShare. You may also mail a separate check for any amount payable to EnergyShare to P.O. Box 91717, Richmond,VA 23291-1717. Mailed on Nov 19, 2o19 v COUNTY OF ALBEMARLE O e e Department of Finance 401 McIntire Road, Room 135 Charlottesville, VA 22902 4579 � r'/IbMN NOTICE OF REAL ESTATE TAX 2019 REAL ESTATE TAX RATE $0.854 PER $100 *************AUTO**5-DIGIT 22902 8185527 8938-RE2 4661 2 3 M ADAMS, CYNTHIA LYNN REVOCABLE LIVING TRU 3635 SCOTTSVILLE RD CHARLOTTESVILLE VA 22902-7414 Ilrllullvllrmr^ddrrullrrull411rlllllllhhlrlhlhlll ACCOUNT # 40421 PARCEL: 10200000001300 LOCATION: 3625 SCOTTSVILLE RD CHARLOTTESVILLE, LEGAL I: ACREAGE LEGAL 2: DISTRICT: MORTGAGE: GUILD MORTGAGE COMPANY PLEASE SEE REVERSE SIDE OF THIS NOTICE FOR ADDITIONAL INFORMATION FOR QUESTIONS: (434)296-5851 TDD 711 • w .albemarle.or,, HOURS OF OPERATION: MONDAY - FRIDAY a:00AM - 5:00 PM SPECIAL INSTRUCTIONS IF TAXES ARE ESCROWED IT IS THE RESPONSIBILITY OF THE TAXPAYER TO CONTACT THEIR MORTGAGE COMPANY TO ENSURE ALL TAXES INCLUDING SUPPLEMENTAL BILLS ARE PAID BY THE DUE DATE. FILE NAME: 111/19 ADAMS, CYNTHIA L r VA 2290LAND VALUE: 107100 la IMPROVEMENT VALUE: 111:200 LAND USE DEFERRAL: EXEMPTION: Mortgage Company has been Billed. TAX YEAR BILL DESCRIPTION MONTHS ASSESSMENT CURRENT PRIOR YEAR TOTAL v TAX DUE 2019 1 ST HALF TAXES 6 218,300 0.00 m 2019 2ND HALF TAXES 6 218,300 932.14 Total due by 12/05/2019: ____________________________________ UE IACH AND RETAIN THIS PORTION FOR YOUR RECORD ______________________________________ ♦ RETURN THIS PORTION WITH YOUR PAYMENT Convenient Payment Methods • To pay online or by phone using credit card, electronic check, or PayPal, visit www.albecoad,org/paytaxes or call 1-866--820-5450. There is a2.5%+ 30¢ convenience fee for credit/debit cards and $1.50 fee fore -checks. To pay by mail using a check, detach this portion and mail it with your check to the address shown. Make check payable to County of Albemarle. To pay by mail with a credit card, fill out your credit card information on the reverse side and mail your coupon to the address shown. There is a 2.5% convenience fee for credil/debil cards by mail • To pay in person, visit the Finance Department at 401 McIntire Rd, Charlottesville, VA; or pay 24/7 using the Automated Payment Kiosk; or drop your payment at one of the boxes conveniently located outside the County McIntire building or County 5th Street building (1600 5th Street Extended, Charlottesville, VA). There is a 2.5% conveniencefeefor credit/ debit cards when paying in person. To setup an automated debit from your bank account, visit www.albemarle.org to download an authorization form, or call (434) 296-5851 to request a form be mailed to you. This would apply for the next tax deadline. $932.14 40421 NOTICE OF REAL ESTATE TAX se n PARCEL: 10200000001300 T.Wm NAME: ADAMS, CYNTHIA LYNN AMOUNT DUE IF PAID BY MORT CO BILLED C3 $932.14 �0 %OR $10 PENALTY, WHICHEVER IS GREATER, IF PAID AFTER DUE DATE • • F $ MAKE CHECK PAYABLE TO: COUNTY OF ALBEMARLE PO BOX 7604 MERRIFIELD VA22116-7604 91020000000130012051900000932144 i S ��FEERSON y�U bQ ALBEMARLE I(NARIORESVILLE I RUVANNA GREENE 1 LOULSA I NELSON THOMAS 1EFFERSON H;ALTH DISTRICT TRANSIENT LDG1NG I REVIEW Operating Name of Business:�t ) S VuT{ �t fS LLC' Facility Address: Tax Map Number: 10,R00 _ 00 - 00 - O i l p2 Subdivision: Section: Lot: i Owner/Agent: hL�Lhnt C a �ci 5 d Gru l n5 Home Phone: c{ -ac15- 1�151 Address: l0q LiV-WDOZI L-a-K' Cell Phone: I-F Ile, bilk Email: cincl.gL a�scs�sS�sCJ Gwlai6ccr Will food be prepared for guests?INJ 0 Total Number Bedrooms: I Owner -occupied: uest: % Water Source (check appropriate): Public Water System _ P ivate Well )l Other (please specify): Sewage Disposal (check appropriate): Public Sewer _ Private Septic Y� Will the proposed lodging involve any new construction? I If so, please specify: c_-i p I ) I Signature (owner or agent) . Date: IO 31 I I Health Department Use VDH PERMITTING REQUIRED: _B&B Permit _Hotel Permit SEWAGE DISPOSAL SYSTEM: I Adequate / Approved A review of our records and/or assessment by a licensed profe: information available, has indicated that the existing sewage d and reserve area (whe indicated) appears to have been desi capacity for the proposed use. This does not imply that the ex continue to function properly for any period of time. A site vis may not have been pe ormed. • Note: For optimum preven ative care, septic tanks should be pum� sewage hauler every 3 to 5 years. Inadequate A review of our recordIand/or assessment by a licensed pro information available, Nas indicated that the existing sewage adequate for the proposed use. WATER SOURCE: 'Approved Not Approved • B&B (w/ food service): coliform bacteria & nitrate testing rer initially, then annually thereafter, prior to permit renewal. • Transient lodging w/o recommended annuall COMMENTS: SeQ�,� sqS Health Department Officia service: coliform bacteria test r ional, and all other posal system (SDS) ed with adequate ing SDS will and inspection out by a licensed and all other system is not initially, tdved fu 3- bJrdd, Page 2 of 2 /L 2 /y Date