HomeMy WebLinkAboutHS202100011 Approval - County 2021-05-28Homestay
Zoning Clearance Application
Submit this completed application with the following online or to the address above:
,• +'• Albemarle County
Y'•`F Community Development
_ - 401 McIntire Rd., North Wing
Charlottesville, VA22902
ae,v Phone 434.296.58321 Fax 434.972.4126
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 bythe Zoning Administrator)
1. Homestay Information
Residentiollyzoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by -right. Use of accessorystructures (if built beforeAugust 7, 2019) is
only permitted by -right on rural area parcels of 5+acres. Whole house rental is only permitted on rural area parcels of 5+acres.
ADDRESS:
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CITY, STATE. ZIP:
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TAX MAP PARCEL (IF KNOWN):
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ZONING (IF KNOWN):
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ADVERTISED NAME OF HOMESTAY(IF APPLICABLE):
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ACREAGE OF PARCEL:
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NO. OF GUEST BEDROOMS:
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USING ACCESSORY STRUCTURES?
0 YES R NO
WHOLE HOUSE RENTAL?
I OYES ONO
2. Property Owner/Operator Information
NAME:
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HOME ADDRESS:
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CITY, STATE. ZIP:
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PHONE NUMBER:
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EMAIL:
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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:
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HOME ADDRESS:
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CITY, STATE, ZIP:
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PHONE NUMBER:
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EMAIL:
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4.Signature
I hereby apply for approval to condl
the property or that I have recieved
restrictions on homestays, that I un
them, ar16 tW will
certify that this address is my legal residence, and that I own
estay as a resident manager. I also certify that I have read the
SIGNATURE: I /////J• /% f�/J ////�'/i I DATE:
Fee Amt: $158^ �Date Paid: 4 5
Receipt tt: 1a.� 7_X7.ol
Ck#: 006
Received
l!by:
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FOR OFFICE USE ONLY
Safety inspection date: � lL 0 Pass Xail
VDH Food Service (if necessary):
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2nd in pection date:_ ®Pa I�Fail
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Date
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