HomeMy WebLinkAboutHS201900023 Approval - County 2021-05-07FOR OFFICE USE ONLY
'et Amt: $ [1S8
Receipt #: 11
1. Applicant/Owner Information
HS#
Date Paid:L�,f_ By: �I"`✓�'t6L
Ck# 1 O� By:
NAME:
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E-MAILADDRESS:
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MAILINGADDRESS:
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2. Homestay Information
TAX MAP AND PARC
(OR ADDRESS, IF UNKNOWN ER
04000 —DODO^ 07—+QO
ZONING:
ACREAGE
HOMESTAY NAME:
Sid
RESPONSIBLE AGENT NAME
M(t e,1
SAM E AS ABOVE (OWNER)
RESPONSIBLE AGENT EMAIL:
emirvid, SI •�
RESPONSIBLE AGENT PHONE:
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RESPONSIBLE AGENT ADDRESS:19m
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3. Verification of Requirements
NUMBER OF GUEST BEDROOMS:
USING ACCESSORY STRUCTURES?
PROOF OF RESIDENCY PROVIDED?
FLOOR PLAN SKETCH PROVIDED?
3
YES NO
NO
ES NO
PARKING REQUIRED:
TOTAL HOMESTAY USES ON PARCEL
'•
Dwelling 2ee
Number of Guest Rooms
♦O
Total Off-street Parking ®
I
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 OWNER/APPLICANT:
DATE:
PRINT NAME
DAYTIME PHONE NUMBER:
ma
8'
Approved [ Approved with Conditions [
Zoning Official: at. Date: 14'J�7( aI
VDH Approval Date: — Building Official Approval Date: Fire Marshal Approval Date:
Conditions
Denied[ I
SUBMIT ONLY THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL, AND YOUR $158 APPLICATION FEE
www.albemarte.org/development/ APPROVED v. 8/14/19 1 Page 5 of 6
by the Albemarle County
Community[ o e t[,le'aftment
Date
File
Provide Sketch Here or Attach Sketch to This Application
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www.albemar(e.org/development/ v. 8/14/19 1 Page 6 of 6
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Homestay
Zoning Clearance
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Albemarle County
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401 McIntire Rd.,North Wing
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Charlottesville, VA 2902
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CAMPBELL, NATHANIEL & EMMA KITCHEN, RILEY G JR OR TAMELA D LYONS, JOHN 1 OR KRISTIN J
CAMPBELL 3024 PIEDMONT PL 4881 SUGAR HOLLOW RD
2992 PIEDMONT PL CROZET VA, 22932 CROZET VA, 22932
CROZET VA, 22932
MOUNT JULIET FARM LLC SUGAR HOLLOW FARMS LLC
63 FOREST AVE SUITE 5B P 0 BOX 295
LOCUST VALLEY NY, 11560 WHITEHALL VA, 22987
Short -Term Rental Registry
Annual Application
Albemarle County
Community Development
401 McIntire Rd. North Wing
Charlottesville, VA 22902
C:r
Phone 434.296.5832
www.albemarle.org
Prior to opening for business, all operators of short-term rentals (including homestays and previously approved bed and breakfasts and
accessory tourist lodging rentals) must:
• Register with this form
• Obtain an approved zoning clearance (requires VDH and building/fire safety inspection)
• Register for a business license and remit reouired taxes
Annually following the initial approvals, all operators of short-term rentals must:
• Renew their registration with this form
• Pass a fire safety inspection
• Renew their business license and remit reouired taxes
Fields marked with an *asterisk are the minimum required for registration.
1. Short Term Rental Information
A whole house rental is a short term rental of a home during which the owner is not required to be present. Whole house rentalsare only permitted on
Rural Area parcels of 5+acres.
'APPROVED HOMESTAY(HS), BED AND BREAKFAST(BNB), OR ACCESSORY
TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER (IFAPPLICABLE):
7
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'ADDRESS:
on V, M
'CITY, STATE, ZIP:
(l/7,�-1-1 t /A_
I V�1T
TAX MAP PARCEL (IF KNOWN):
_
ZONING (IFKNOWN):
f VT
GUESTBEDROOMS:
WHOLE HOUSE RENTAL:
�yES ONO
2. Property Owner/Operator Information
'NAME:
'HOMEAODRESS:
mS7/2
/
'CITY, STATE, ZIP:
.e d
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PHONE:
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EMAIL:
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3. Responsible Agent Information
The responsible agent must be available within 0 miles of the homestay at all times during a homestay use, and must respond and attempt in good faith to
resolve any complaintswithin 60 minutes of being contacted.
OWNER/OPERATOR IS RESPONSIBLE AGENT:
I _VYES ONO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
Iris6ntra •
HOME ADDRESS:
�� ` a r
CITY, STATE, ZIP:
T z�
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PHONE:
7 17_TSS-b
EMAIL
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FOR OFFICE USEONLY
FeeAmt: 0$27 0$0 with clearance application
Date Paid:--/—_/ ccepted Deni
Ck#:
Reviewed by:
Received by: j� ,2r�.
Registration Date:./sit/
www.albemarle.org/homestays v. 9.17.201 Page 1 of 1