HomeMy WebLinkAboutHS202100019 Approval - County 2021-10-22Homestay
Zoning Clearance
APPROVED
by the Albemarle County
Community Develo en De
Date 47.Ilyl
Submit this completed application with the following online or to the address above:
I. Floor plan/property sketch with labeled structures used for the homestay, guest bedrot
and signage for the homestay, labeled setbacks, and parking (minimum 2+ 1 spot/guest
2. Copies of two forms of verification of residency (one government issued with photo ID
include driver's license, voter registration card, U.S. passport, others as approved by the
Albemarle County
Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296.58321 Fax 434.972.4126
Application fee: $158
owner's bedroom, outdoor lighting
n--I
listing the address - acceptable forms
1. Homestay Information
Res
ned
onlyde rmitt ed bY-r and rural area parcels s less than 5 acres may have 2 guest bedrooms by -right. Use of acc ssorystructures if built before August 7, 2019) is
only permitted by -right on rural area parcels of 5+acres. Whole house renfol is only y permitted on rural pa els of 5+acres.
ADDRESS:
CITY, STATE, ZIP: I /' _o u_+- ` , J\ 7 1.4 7
TAX MAP PARCEL (IF KNOWN): I0 4 DOO G OCXp ci I Z E Ci
ADVERTISED NAME OF HOMESTAY(IFAPPLICABLE):
C.G.a-rit •e Id
NO. OF GUEST BEDROOMS: 'Z USING ACCESSORY STRUCTURES?
2. Property Owner/Operator Information
NAME: l
ZONING (IF KNOWN):
ACREAGE OF PARCEL: 10. � 7
HOUSE RENTAL? 1 0 YES ID NO
HOMEADDRESS:
CITY, STATE, ZIP:
u
PHONE NUMBER: 1 :,{ � ! S • EMAIL:
4 S 2SS
6' GC4- 1 1Z 36) fyNia�i.6
3.Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay at all times during a homestay use,
resolve any complaints within 60 minutes of being contacted. and ust respond and attempt in good faith to
NAME:
HOME ADDRESS: (X
CITY, STATE, ZIP: Zo , a/
PHONE NUMBER:
ccarb I zv�,
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 man get. I also certify that I have read the
restrictions on homestays, that I understand them, and that 1 will abide by them.
SIGNATURE. C /_ 7
ATE: q , t Z. , Z
FOR OFFICE USE ONLY
Fee ArnL$158 Date Paid: J Safety inspection date:
4 G 2323 ss ®Fail 2nd nspectlon date: ss ®Fail
Receipt A: �(L(���e,�\�iSO���rl VDH Food Service necessary):
®F Ian Par' H D
Ck#: r Notes: I -
Received by:
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pprovecl Denied
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