HomeMy WebLinkAboutHS202100010 Application 2021-04-05Homestay
Zoning Clearance Application
Albemarle County
J;r, Community Development
t ; 401 Mclnbre Rd., North wmg
Charlottesville, VA 22902
Phone 434.296. 58321 Fax 434.972.4126
! Submit this completed application with the following or to the address above: Application fee:$158
1. Floor plan/property sketch with labeled structures used for the homestay,guest bedrooms, owner's bedroom outdoor lighting
and signage for the homestay, labeled setbacks. and parking (minimum 2 + 1 spot/guest bedroom).
2. Copies of two forms of verification of residency (one government issued with photo ID♦ one listing the address- acceptable forms
include driver's license, voter registration card, U.S. passport, others as approved by the Zoning Administrator)
1. Homestay Information
Residentiallytuned and ruml area parcels of Jess than 5 acrrs may have 2 guest bedrooms by -right. Use of accessarystructures (if twit before August 7, 2019) is
only permitted by -right on rural area parcels of 5* acres. Whole house rental is only pem fitted on rural area parcels of 5. acres.
ADORE55
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CITY. STATE. ZIP
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TAw MAP PARCEL (IF KNOWNI'.
ZONING 1V KNOWN)
AD. "e FT15ED NAME OF HOMESTAY (IF APPLICABLE).
ACREAGE OF PARCEL.
NO OF GUEST BEDROOMS
'
USING ACCESSORY STRUCTURES'
O YF5 ONO WHOLE HOU5E RENTAL?
® "F`' ONO
2. Property Owner/Operator Information
NAME /Qi/17 �ivE� it'N .41v, M(Clr►rEl •- Eu �1Ff Ku -UM,'
HOMEADDRESS
CI TY. STATE.ZIP Uf VA zzro
PHONE NUMBER 3o3 • bra , '1 i5Q _ - — EMAIL eliztbcf7l kdlwt l (?, Jrt1Lij.,opA j
3. Responsible Agent Information (/ ✓_
The responsible agent must be available within 30 miles of the h omestoyat all time; during a homesmy use, and must respond and attempt in good faith to
resolve any complaints within 60 minutes of being contacted
NAME R'M( If✓ A'-6G�E
HOME ADDRESS
(IT r, STATE, 71P
PHONE NUMBER EMAIL
4. Signature
1 hereby apply for approval to conduct the homestay identified above, and certify that this address is my legal residence, and that 1 own
the property or that I have recieved a special exception to operate the homestay as a resident manager. I also certify that I have read the
restrictions on homestays, that l understand
them, and that l will abide by them. r
DATE
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FOR OFFICE USE ONLY
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