HomeMy WebLinkAboutHS202100009 Application 2021-04-22Homestay
Zoning Clearance Application
Albemarle County
,,,N f Community Development
< 401 McIntire Rd., North Wing
y � r, Charlottesville, VA22902
Phone 434.296.5832 1 Fax 434.972.4126
Submit this completed application with the following Online or to the address above: Application fee: $158
Floor plan/property sketch with labeled structures used for the homestay, guest bedrooms, owner's bedroom, outdoor lighting
VVV / and signage for the homestay, labeled setbacks, and parking (minimum 2 + 1 spot/guest bedroom).
/2. Copies oftwo forms otverificationofresidency(onegovernmentissuedwithphotolD+one listing the address- acceptable forms
V include driver's license, voter registration card, U.S. passport, others as approved by the Zoning Administrator)
1. Homestay Information
Residentially zoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by -right. Use of accessory structures (if built before August 7, 2019) is
only permitted by -right on rural area parcels of 5+acres. Whole house rental is only permitted on mml area parcels of 5+ acres.
ADDRESS:
95 WllJOW I,.ak21LTVIvCi
CITY. STATE, ZIP: GhG(.i'10} 6vi tI-e-) VA � OA
TAX MAP PARCEL (IF KNOWN):
01 qe I—Ock 01�'"bor A
ZONING (IF KNOWN):
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
ACREAGE OF PARCEL:
NO. OF GUEST BEDROOMS: I
I
I USING ACCESSORY STRUCTURES?
$
® NO
11 WHOLE HOUSE RENTAL?
-Q=Z� ® NO
2. Property Owner/Operator Information
NAME:
Meo-- y &Y- Dv I a'
HOMEADDRESS:
4 9 5 W ( I'QW LOLL Y Ie,-
CITY, STATE, ZIP:
`�
V) � l� V A R a- Qy ` o O'
PHONE NUMBER:
& o 1510 V a40 a
EMAIL:
dOV 10.I!
l
11"wt' ' W�l
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay at all times during a homestay use, and must respond and attempt in good faith to
resolve any complaints within 60 minutes of being contacted.
NAME:
He A+iqh bv)al�
HOMEADDRESS:
'L{ �I, IO�JLpjq
�r�
CITY. STATE, ZIP:ty^
V(
`/Q qYJ
I e tl' as ' O tl
PHONE NUMBER:
I.�—OC� .� at,�O
EMAIL
'!
Ul&--'
�t
lI
h ^r�
1 `Ol V\&i
I•l.N
4.Signature
I hereby apply for approval to conduct the homestay identified above, and certify that this address is my legal residence, and that I 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 I understand them. Old that I will abWebv them.
SIGNATURE: L �&) U///7/u-(,�vj sA ) I DATE, 131ao I ao a I I
Fee Amt: $158 Date Paid: '
Receipt#: `a,�O,S(J.
Ck#:
Received by:
A
H5# �
FOR OFFICE USE
Safety inspection date: Pass
VDH Food Service (if necessary):
Notes:
2nd inspection date: email
IOOrpldn HyParking li-
Reviewd By:
Dat j�e:nw
pprooveyed
'Ali
lqcl5 willow LaKc 'Dt-tvx
k1c j 04 )314
LI"E5 AND NALLLLS OF THEE � INNSS THIS PLAT AND TH
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ON COMMUNITY PANEL NO; 51003C 042M.
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1464 GREENBRIER PLACE
GMMOTTESVILLE VIRGINIA maj
PH: 434-973-0513
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Lic. No. 2029
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ALISOWLE COUNTY. VMINIA
SCALE: I' - 30' NAlfR 4 2031