HomeMy WebLinkAboutHS202000057 Approval - County 2021-05-27DocDocuSMn Envelo mID: B3BEB5f�3=285C-488D-AW7-73DD64F2666C
Homestay
Zoning Clearance
FOR OFFICE USE ONLY
Fee Amt: $158
Receipt #: b 1
1. Applicant/Owner Information
u Albemarle County
Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
D�ma�`a Phone 434.296.5832 1 Fax 434.972.4126
HS#_�0112— 5dG4r J",?-
Date Paid: D 2 n gy: C'.,Z%(_ ��.�tt��j �f�—t T2?-•'L
Ck# � yzC/ By: -
NAME: Cathy and Kirk Train
E-MAILADDRESS; CVT et rai n@gmaT .com PHONE, 434-971-4957
MAILINGADDRESS' 705 Mechums West Drive Charlottesville ZZ903
2. Homestay Information
TAX M PANDDRESS PARCEL NUMBER
(OR AODRESS,IFUNKNOWN)
/\ r 0 ,l
v/�, � V
- O 0 - O 0 - ' ` �3 F
V U
ZONING:
ACREAGE
HOMESTAYNAME:
vw'wi w'
a
Plainfields cottage
RESPONSIBLE AGENT NAME
Same as above
SAME AS ABOVE (OWNER)
RESPONSIBLE AG ENT EMAIL:
0 C4.1
RESPON-98LE AGENT PHONE:
RESPONSIBLE AGENT ADDRESS:
3. Verification of Requirements
NUMBEROF GUEST BEDROOMS:
USING ACCESSORY STRUCTURES?
PROOF OF RESIDENCY PROVIDED?
FLOOR PLAN SKETCH PROVIDED?
1
NO
X YES NO
X YES NO
PARKING REQUIRED:
TOTAL HOMESTAY USES ON PARCEL
excelling 2
NumberoTGue tRooms i1
TOW OWSPr Parting f
1
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:
CAr 1„_,
12/11/2019
PRINT NAME:
DAYTIME PHONE NUMBER:
Cathy Train
434-971-4957
Zoning Official
VDH Approval
Conditions
Building official
Approved[ I
Approved with Conditions
Date: 6AM
Denied [
Date: I r Fire Marshal Approval Date: hl c-
C,
Date ,
SUBMIT ONLY THIS PAGE, YOUR SKETCH, YOUR VDH APaI, nnlnyo�B APPLICATION FEE
www.albemarle.org/development/ v. 8/14/191 Page of
74
Ul
T
74
w
CMD
-:4
Lm
> x
m
h
70 ft
llc�
VC,
C)
IV
v LCA
w
71
w
w
L
74
71
w
74
03
El CD
CD
rL
a)
*�EP.SON Np
'44�1 40,
_4
CA
ALBEMAPLE CHAPLOrTESVILLE FLUVANNA
GPEENE LOUISA NRSON
�.TJHD.�G
THOMAS JEFFERSON HEALTH
DISTRICT TRANSIENT LODGING
REVIEW
Operating Name of Business: 17 26� /_ W_/_ 6�-)
Facility Address: -7b t3- IL-Ce ClUemi-_ Akl,4- C6K
Tax Map Number: C `5_2 6 G - G 6 - 06 - 6 053 F 6
Subdivision; gaial'y'Ai�E —Section: --� Lot: Aa!5_3F_6
Owner/Agent: Home Phone:
6 LZ41V 4� Ct
Address: W2 1&_ Cell Phone:
X'_1?0,)- Email: 1112Xef
Will food be prepared for guests? 11L
Total number bedrooms in rental unit, guest + owner -occupied:
I
Water Source (check appropriate): Public Water System
Other (please specify):
Sewage Disposal (check appropriate): Public Sewer
Will the proposed lodging involve any new construction? tk)
Private Well 4-�
Private Septic L--
Page I of 2
If so, please specify:
Signature (owner or agent) ax , Date: j A (C /-�"O
Page 2 of 2