HomeMy WebLinkAboutHS202200001 Permit 2022-02-11APPROVED
by the Albemarle County
ty
Homestay w,,. Comma ryDevelop
Community D velopment Dep � ^ ,Community Development
Date ..= 401 McIntire Rd., North Wing
Charlottesville, VA 22902
Zoning Clearance Appfiftion------- `ff„n:,:�, r Phone 434.296.58321 Fax 434.972.4126
Applicationfee. $173 76
Submit this completed application with the following Qu&Q or to the address above: Apwwelan$119+7Khmiorvsurdurre$47a.lr&pft-Bonf50
i 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 4- 1 spot/guest bedroom)..
Copies of two forms of verification of residency (one government issued with photo I D + one listing the address -acceptable forms
include driver's license, voter registration card, U.S.passport, others as approved by the Zoning Administrator)
It. Homestay Information
Residentiagymned and rural ores Parcelsof less than 5 acres may have 28uestbedlooms by -right. Use of accessorystructures (if built before August 7, 2019) is
onlypermitted by-righton rural area parcels of5+acres. Whole house rentolis onlypermitted on rural oreaparcelsof 5+acres.
ADDRESS:
3 CF p Graysrn ex—, Fla.
CITY STATE, 21P:
Ct�l•I�L t/j} "Z2 O�
TAX MAP PARCEL (IF KNOWNI
ZONING IIF KNOWN):
ADVERTISED NAME OF HOMESTAY (IFAPPLICABLE):
/ V 10d3',,� MA,�d� ,� /'_!a P
�+®NO
ACREAGE OF PARCEL
NO. OF.GUEST BEDROOMS:
3
USING ACCESSORY STRUCTURES?
❑ VES
WHOLE HOUSE RENTAL?
I JMYES ❑ NO
2 Property Owner/Operator Information
NAME:
O
HOMEADDRESS.
CITY, STATE. ZIP.
%. eltc- O
VJ
It VA 96 J
PHONENUMBER:
�V��rf,f 9 Z�
EMAIL:
e� Owl
& Responsible Agent Information
NAME:
HOME ADDRESS:
3 Q
CITY, STATE, ZIP:
- /I''
4nNoiod�1"VrIle-
/�
✓a
�r
2z Q J
PHONENUMBER.
3ro-- t( 23
EMAIL:
,C Signature
1 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 1 have read the
restrictions on homestays, that I understanci 1Wem,_and that I will abide by them.
SIGNATURE. _ — — DATE I %//O1•L2 —�
FOR OFFICE USE ONLY
Fee Amt$169+4% Dare Paid: II �� Safetyinspection date: Opass AFail 2ndinspectiondate. c2-3-22. ss OF.,
Receipt 4 C VDH Food Service (if necessary): 0 Flaarplan 0 Fprking 0 ID
Ck4: CCr Nolen 4...� a� LZ'eviewd By.
Receiwed tryf
Date: AZ :3-7a J
H s o j h I 17L Ver: ❑ Approved ❑Denied
fl °r Albemarle Coonty
Community Short -Term Rental Registry 3 m G opment
4hadott McIntireNorth902
enanoteen,nie, vAn9oz
Annual Application aCiN.! Pbone43429658.32
ww Abemarlecrg
1.Short-Term Rental Information
L �`.
A wfioleh&seretital ka'short termntriUllofa'holnedurl4whichthe owneris not required to be present`trlMiftMureraltGfC are only perrtdlted on RU{al;y
ws.t
ED HOMESTAVIHISIFIDANO BREAKFAST (8NB),ORACCESSORY '
IODGiNG(ATtjctEARANOE PERMIT NUMBgr"'+t�
34or�tssmROA
nE.l
E4GUMBIRY"l-
PAR[Ei(l iA5 .zONNO(IF
Kk6wW
3
BYES ONO
,
9 orn. He fluunarRinerntnr Information
eAGoaEsx
� rff0 C7'ruSSm2fG
cnr,sraier
CL ea VJC53-sV d 't A 22E% O'S
Pl+oet,r `• ``'
�o�3cFr 99z3 Eli _ _
g �renev ewt 1.
3. Responsible Agent Information
BYES ONO
IF NO,f:OMPLETE RESPONSIBLE AGENT INFORMATION BELOW
r ❑ Accepted %E
Reviewed by
vwwalbemade org/honmtsYs Y.9.17.20I Page loft
1
uNP%i
YI fC✓EN
\YERRECiM
�
�.;
_—
�
I//'•
Evan
nwwm*N
orr+tE
�S
we
$
1
cE,..
FI=1
lMRfi
� �0 �k"ct56m�t2
MRCWN
',
Fu -
Pkaa%A+ � 869ROM1
Uro �kSFuP
s m
MTS10RNf fiMKaE '. WP
VY1fIGR1PJ.
t41n�
�OcJje" I PVG (-
j Y o &—a55 {r.C't_Q_-
door-061.-: rmade bb b;r, lu.
r34�� �rcassw�ere
L
-)7(l To '.015 -)�,
AQ— ilt��V `�cl 3��77U.1 Stn17�(✓ .�CK7��
-mawss��� Ohl
pA,, -; AJ