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Home My WebLink AboutHS202200010 Application ^0 •, Albemarle County VI Homestay ? Community Development 401 McIntire Rd,North Wing � .-` Charlottesville,VA 22902 Zoning Clearance Application �a�" Phone 434 296 5832 I Fax 434972.4126 Applicatk 173.76 Submit this completed application with the following:i iti!i�'or to the address above: Agolirarm$119 rearMgrr surd.>r� 6.4npectinsSa_ / 22.0D0 I 0 1. Floor plan/property sketch with labeled structures used for the homestay,guest bedrooms,owner's bedroom,outdoor IightTg `J F and signage for thefi'omestay,labeled setbacks,and parking(minimum 2+1 spot/guest bedroom). 2. Copies of f two forms of verification of residey(one government issued with photo ID+one listing the address-acceptable forms include driver'siicense voter registraticsicCard,U.S.passport.others as approved by the Zoning Administrator) 1.Homestay information Residentially zoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by-right.Use of accessory structures(if built before August 7,2019)is only permitted by-right on rural area parcels of 5+acres Whole house rental is only permitted on rural area parcels of 5+acres. — — ADDRESS �Q (t- 22-(0$) Davis S1h01 Rd• CITY STATE.ZIP EO.rlysvr tie, VA 7-2_43 TAX MAP PARCEL W KNOWN). O l 10°-G O-dG_ 0 0 7 D(Q ZONING IIF KNOWN)" ryr f UNt�01/ ADVERTISED NAME OF HOMESTAY(IF APPLICABt El ACREAGE OF PARCEL. J NO OF GUEST BEDROOMS. I 1 USING ACCESSORY STRUCTURES, yP'YES 0 NO WHOLE HOUSE RENTAL'', 0 YES 'NO 2.Property Owner/Operator Information NAME boor ra Yvinn + G1.4,(5,o Le pore. HOME ADDRESS a1C� Dc.VI$ SI1D() R CITY STATE ZIP. 001 I cv l I1C, VA Z2 c 3 L PHONE NUMBER _ EMAIL F4eR n1 e 2(o% rAa'I- Co w-* 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 ilvi)(i-Yr, W HOME ADDRESS a a"I v Davis S lit 6 P 1Zd • CITY,STATE7JP e.c f1 SVI lie, VA 2Z53(° PHONE NUMBER L fS y-5+}�-�_ 30 9 g I EMAIL q F-i-e.Q e 5a(,i4 07 41M4 I 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 manager.I also certify that I have read the restrictions on homestays,that) erstand them,and that I will abide by them. SIGNAT�eiF 1�kL GATE. of a — o� FOR OFFICE USE ONLY Fee Arnt$169+4% Date Pad Safety inspection date - 0 Pass ❑Fad 2nd inspection date: 0 Pass ❑Fail Receipt t VDH Food Service Of necessarv), � _. ❑Floomian 0 Padang 0ID CVA Notex Revewd BY __— Received by Date H 5 It -- C]Approved CI Denied 2/22/22,4:22 PM Google Maps Go g!e Maps 'a c 1/4"1 't e,191 a V.,a{ iktil t p. 9'� v . so0 raga Nj -c ! ,Jr ;� ‘)cr� ,i, A\e0 l ,-0,) .vs 4a rl'Ce {I67 �oG'�� ey� PINNACLE dh h!.\\\ ( � a CUSTOM PAINTING I (5 ,) Or 67,E lc;) f Davis Shop Rd Go ..gle ',ye pa, (! Map data 02022 200 ft I I https.//www google com/maps/(g38.20686:78.576323,17z 1/1 I A g� S ''‹ �rag4 , 1- cs---)i, c?..0 s 4, cl-. 41k t - (r; ____---- _,moo / X titN- Ise Si- 1 A X - bv,}si at oZi rots Ievet_ r r6 IQ 0 101 by boil. / „��'v AcA, _ ASSESSMENTS UNIT vt.x County of Albemarle AlbemarleCountyFinance@albemarle.org � / -- -fe'I ZF296-5851,Opti n ' FINANCE AND BUDGET DEPARTMENT �-�------�-- ��- //i REVENUE ADMINISTRATION DIVSION Monday-Friday:8 AM-5 PM . f ZRair"t� 800-828-1120 TTY-Fax:434-243-7906 2022 NEW BUSINESS LICENSE APPLICATION STEP 1: DOCUMENTS REQUIRED FOR A NEW BUSINESS LICENSE(SELECT ALL SUBMITTED WITH APPLICATION) 'X _:__i Zoning Approval from Community Development Department(Required but does not have to be obtained prior to applying for a Business License)°n)1,vt- Social Security Number or Federal Employer ID(FEIN)number(Apply for FEIN at www.irs.g4y/pmall-business) a fe t eCA -;If Business has a trade name,need a trade name registration with the SCC Lywvf_scc.yirgln a.gov) f S ;'If Business is general partnership,limited partnership,corporation,business trust,or limited liability company,need copy of state corporation commission registration( :. . .q,-) If Contractor,need a copy of contractor's license from the State Board of Contractors and certificate of liability insurance STEP 2: ENTER START DATE-APPLY WITHIN 30 DAYS FROM START DATE TO AVOID 10%LATE FILING PENALTY DATE BUSINESS BEGAN IN ALBEMARLE COUNTY: 'i . t , (MM/DD/YYYY1. r- 't c1 4%' STEP 3:TYPE OF BUSINESS(SELECT ONE) d'Individual/Sole Proprietorship Ll Partnership 0 Corporation El LLC El Public Service Corp 7,Other ` STEP 4: BUSINESS INFORMATION 1 Legal Name: 1 A4ttroN Vt.)i 4 t1 Trade Name: Tax Identification Number(FEIN or / Website• ss#. aU?SL,S)-to AolSlis2,(.,`f uessLocation Address: a./o 14J Shoe ad C r/E ,Sv, 11e, VA 23 i;2-a Mailing Address: S�f'e-- Contact a i� �I Email ,-. Telephone: Name: (I c k 1'r, ,a li ,t UiY C F 1,..¢,1,:ri.,:51--- 4 c..' r,11.1,;);#. i e P t `/-`i L(7-fit;y 7_ STEP 5: BUSINESS ACTIVITY-MUST PROVIDE GROSS RECEIPTS TO DETERMINE BUSINESS LICENSE FEE OR TAX! Provide a brief description of your business: yyr zS-f-0:0 /(A I2 t U r2,-,1-,1 C 3 0 do Y Gross Receipts includes receipts fora sales made,services rendered,or activities catducted from a place of business within the County,including ABC Sales. (ABC sales must be included with total retail or wholesale gross receipts). tG$j}Qty . IF your gross receipts are$25,000 or less,the business license is waived and there is NO FEE. • IF your gross receipts are greater than$25,000 but less than$160,000,there is a$50 LICENSE FEE-LICENSE FEE DUE WHEN YOU APPLY . IF your license tax is based on a Flat Tax(see Table 2 below)the TAX IS DUE WHEN YOU APPLY. • IF your gross receipts are$100,000 or more(see Table 1 below),the TAX IS DUE JUNE 15,2022,if applying after this date,the tax is DUE IN 30 DAYS. If you began AFTER 1/1/21 and PRIOR to 1/1/22;enter Actual Gross Receipts for 2021 AND estimate 2022 below $ 2022 Estimated Gross Receipts $ If you began on or after 1/1/22,enter Estimated Gross Receipts from your start date thru 12/31/2022 $ 1?i WO I LICENSE TAX RATES CALCULATION FOR GROSS RECEIPTS OF$100,000 OR MORE t Tax Year � l Gross Receipts Multiply By Rate(Use Table 1 Below) Equals Business License Fee _. ( 2021 Actual Gross Receipts I $ X $ 2022 Estimated Gross Receipts I $ X $ TABLE 1-LICENSE TAX RATES FOR GROSS RECEIPTS OF$100,000 OR MORE(Select below) ❑Retailers or Retail Merchants $0.0020 0 Wholesalers or Wholesale Merchants 1 $0.0005 ❑Regan,Personal,Business,and Other Services $0.0036 ❑Rental of Houses,Apartments,or Commercial Properties $0 0020 ❑Financial,Real Estate,and Professional Services $0.0058 0 Public Service Corporations $0 0050 ❑Contractors,Developers,and or Speculative Builders $0.0016 ❑Utility Company $0.0050 ❑Vending Machines or Coin Operated Devices(Retail Merchant) $0.0020 0 Direct Retail Seller;Telephone,Internet and/or Mail $0.0010 TABLE 2-IF YOUR BUSINESS IS ONE OF THE FOLLOWING,THE BUSINESS LICENSE IS THE FLAT TAX LISTED BELOW(Select below) ❑Coin Operated Devices for Amusement $100 0 Peddlers,Mobile Food $50 ❑Fortunetellers,Clairvoyants,etc. $500 ❑Peddlers,Non-Food $500 ❑Carnivals and Circuses(For Profit) $500/Day 0 Bondsmen $150 ❑Carnivals and Circuses(Not for Profit) $25/Day 0 Itinerant Merchant,Food $50 i ❑Show and Sale-7 Day Period $50 0 Itinerant Merchant,Non-Food $500 0 Show and Sale-30 Day Period _ $150 0 Budding/Savings&Loan Assoc $50 i ❑Show and Sale-365 Day Period $600 BUSINESS LICENSE FEE($0,$50.CALCULATED,OR FLAT FEE): C$ CONTINUED ON PAGE 2-SEE BACK OF FORM FOR STEPS 6-11 401 McIntire Road,Suite 133 I Charlottesville,VA 22902 E STEP 6: VIRGINIA ALCOHOLIC BEVERAGE CONTROL(ABC)LICENSE(S)-SKIP,IF NOTAPPLICABLE Select all that apply and enter ABC license fee(s).Albemarle County ABC License(s)REQUIRE an active Commonwealth of Virginia issued ABC license. BEER ONLY: 0 On Premises($25) 0 Off Premises($25) 0 On/Off Premises($50) ❑Wholesale Beer Distributor($75) BEER AND WINE: 0 On Premises($37 50) 0 Off Premises($37 50) 0 On/Off Premises($75) MIXED BEVERAGES: 0 0-100 Seating($200) 0 101-150 Seating($350) 0 151 or more Seating($500) WINE INDUSTRY: 0 Winery License($50) ❑Wholesale Wine Distributor($50) 0 Farm Winery(No Fee) 0 Wine Retailer(Gross Receipts) BREWERY: ❑Produce<500 Barrels(Flat Fee$250) 0 Produce 500 or more Barrels(Flat Fee$1,000) 0 Beer Bottler(Flat Fee$500) LDISTILLERY: El Produce>5,000 Gallons(Flat Fee$750) Ell Produce>36,000 Gallons(Flat Fee$1,000) ❑Fruit Distiller(Flat Fee$500) TOTAL ALBEMARLE COUNTY ABC LICENSE FEES:I$ STEP 7:ADDITIONAL BUSINESS LICENSE(S)-SKIP,IF NOT APPLICABLE 2021 Actual 2022 Estimate j CONVENIENCE STORE: Li Sell Prepared Food/Deli:enter actual Gross Receipts for 2021 or estimate 2022 b O Sell Gasoline,enter actual Gross Receipts for 2021 or estimate 2022 ROOM/VENUE RENTAL: ❑Rent Space,Land or Venue,enter actual Gross Receipts for 2021 or estimate 2022 $ TA Rent Rooms for<30 days,enter actual Gross Receipts for 2021 or estimate 2022 $ I c,J AUTO DEALERSHIP: 0 Sell Automotive Parts,enter actual Gross Receipts for 2021 or estimate 2022 $ G Automotive Repair Shop,enter actual Gross Receipts for 2021 or estimate 2022 $ El Auto Wholesale Merchant,enter actual Gross Receipts for 2021 or estimate 2022 $ HOTEL/MOTEL: ❑Restaurant on-site,enter actual Gross Receipts for 2021 or estimate 2022 $ ❑Gift Shop on-site,enter actual Gross Receipts for 2021 or estimate 2022 $ 0 Other Services Offered,enter actual Gross Receipts for 2021 or estimate 2022 $ OTHER-Please'describe.:} )DActua)Gross Receipts for 2021 or Estimate 2022 $` ill I, OTHER BUSINESS LICENSE FEE OR TAX BASED ON GROSS RECEIPTS $ ($0,$50,OR CALCULATED AMOUNT USING THE METHOD FOUND IN STEP 5): STEP 8:ARE YOU CLAIMING A VEHICLE(S)FOR BUSINESS USE? If you are claiming a vehicle(s)for business use or,your federal income taxes,please provide the details below A vehicle used more than 50 percent for business purposes,under the Personal Property Tax Relief Act of 1998(PPTR),is considered by State Law to have a business use and does not qualify for PPTR. YEAR 1 MAKE MODEL YIN I STEP 9: TOTAL AMOUNT DUE TOTAL TAX/FEE DUE FROM STEPS 5,6 AND 7 $ ANY LATE FILING OR PAYMENT PENALTIES DUE: $ (Make Checks Payable to Albemarle County)GRAND TOTAL DUE: $ 1 STEP 10: DECLARATION OF TAXPAYER I declare that the foregoing statements and amounts are true and correct to the best of knowledge and belief I understand that it is a misdemeanor for any person to willfully subscribe to etum Oat is not believed to be true and correct as a to every material matter (Virginia Code 58.1-11) Applicant Signature. v�! Date: d- P- Submit your completed application and supporting documentation via email to AlbemarleCountvFinancealbemae erg,mail to County of Albemarle,401 McIntire Rd,Suite 133,Charlottesville VA 22902,or Fax to(434)243-7906.Submission of an incomplete application or missing required documentation may result in denial of your application,late filing penalties,and late payment fees. STEP 11: FILE BUSINESS LICENSE APPLICATION Submit your completed application and supporting documentation via email to AlbemarleCountyFinance@albemarle.org,or mail to County of Albemarle,401 McIntire Rd.Suite 133,Charlottesville VA 22902.or Fax to(434)243-7906.Submission of an incomplete application or missing required documentation may result in denial of your application,late filing penalties,and late payment fees. Contractors must attach a copy of their State Contractor's license,certificate of liability insurance,a schedule showing gross receipts from all sources,and an itemized list of licenses purchased In other localities.including the gross amount on which the license was based Contractors based outside of Albemarle County should report only gross amounts earned in Albemarle County Please note the Out-of-County's contractor's taxable threshold is$25,000 annually Work-from-Home Business operations are subject to business license taxation,regulations,guidelines,and due dates. Real Estate Brokers exclude receipts paid to agents and must provide a list of agents'name,address,and amounts Wholesale Merchants may substitute gross purchases for gross receipts. Thank you in advance for completing and submitting your business license application and for making your subsequent payment by the stated deadline(s). THANK YOU FOR DOING BUSINESS SS IN ALBEWARLE COUNTY! OFFICE USE ONLY Application Date: I I Processed by. I I Acct Number: I I BL#' I 12/2021 Page2 Annual Application "y Phonea34.2Y6.5g3z 9.�� -�- rq www.albemarle.org Prior to opening for business,all operators of short-term rentals(induding homestay5 and previously approved bed and breakfasts and accessory tourist lodging rentals)must: • Enroll on the Short-Term Rentals Registry with this form , • Obtain an approved r\LAV ci zoning clearance(requires VDH and building/fire safety inspection)V tit • Register fora gt�tsiness license and remit required taxes Annually following the initial approvals,all operators of short-term rentals must: • Renew their enrollment on the registry with this form • Pass a fire safety inspection • Renew their husiness license and remit rewired taxes Fields marked with an'asterisk are the minimum required for registration. 1.Short-Term Rental Information A whole Crouse rental is a short term rental of a home during which the owner is not required to be present Whole house rentals are only permitted on Rural Area parcels of 5+ears. 'APPROVED I1ME$T�1'(HSi,BED AND BREAKFAST(BNB),OR ACCESSORY TOURIST LODGING(ATE)CLEARANCE PERMIT NUMBER OF 11, APPLICABLE): 'ADDRESS: 2 1 D Ct U\S .�ill p 'CRY,STATE,ZIP. f r �4,1 [(f vt A- 2/2A? TAX MAP PARCEL(IF KNOWN). I p 11OG- 06_ek,- bU 11t, ZONING OF KNOWN): l 4/U ndP GUEST BEDILOOMS:� r WHOLE HOUSE RENTAL ❑YES NO 2.Property Owner/Operator Information`� ( / `NAME: --- G 1.t-1 i k) �•(I` 6re been c. ) 'HOME ADDRESS: -- �`A v i S /n�S k o p R/d_' bee ,'CITY,STATE,ZiR,^ ilc (,IIT z-2-e (D - PHONE: E1 C EMAIL / ��/ .(_r!1'i�k ,-5 1'3 q gF��2meS.zGyr� 3.Responsible Agent Information The responsible agent must be available within 39 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 mini tegof being contacted. OWNER/OPERATOR IS RESPONSIBLE AGENT: l I()Lc'ES 0 NO IF NO,COMPLETE RESPONSIBLE AGENT INFORMATION BELOW NAME: S✓lay-(j` tx)IV1 h HOME ADDRESS {'^�? e- -- CITY,STATE,ZIP: PHONE: EMAIL FC#t OFFICE USE ONLY Date Palrk_/J_ ❑Accepted 0 Denied Fee Amt 0$27 ❑$Owlth clearance application Ck N•. Reviewed by Receipt*: Received by. Registration Date:_J_J www.aibemarle org/homestays v.917.201 Page 1 of 1