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HomeMy WebLinkAboutHS202200013 Application 2022-03-29 go , _ . �°�f fly Albemarut 1 Communityle DevelopConyment HomeCC ��®�M 401 McIntire Rd.,North Wing J �,i "•"-) Charlottesville,VA 22902 _ Zoning Clearance ikci' Phone 434 296 5832 I Fax 434 972 4126 FOR OFFICE USE ONLY HS# kl-5 2d22 — 0013 Fee Amt: $ 11 1)149 Date Paid: a//t ID By: Receipt#: I 2-9 5 It Ck# -l a K By: �'[� 1.Applicant/Owner Information U — NAVE '/ ��� Ac i % ' - C A 1-4T2r.L-t---- O E-MAIL ADDRESS f - e t rj—(Ap t O. Fro O �j i J PHONE 0 3 O 1 rj 5 9 \ J MAI_WG ADDRESS , c. % �A t�(,r CJE13 �174 `,��1 A. Co 2. HomestayInformation ST C.RoZ T_ \/A 2z 9 -3-2__ IAX MAP AND PARCEL NU VBER 0s ¶ o 01�! 2300 .OR ADDRESS,IF UNKNOWN)_ x 7 7 Y ZONING . /ACREAGE y4.t Amt. `OMESTAYNAME 1.-AAL,04o(.1%{/ r f 6,04„.":i'S‹.:10 RESPONSIBLE AGENT NAME SLA Z..k3t \ M . e#60`1 SAME AS ABOVE(OWNER) RLS'ONSIBLLAGLNI I MAIL TLSPON>IBL[AGEN I PI ION RESPONSIBLE AGENT ADDRESS 3. Verification of Requirements • NUMBER CF GUEST BEDROOMS USING ACCESSORY STRUCTURES? 2 FORMS PROOF 0=RESIDENCY PROVIDED? FLOOR•LAN SKE-CHPROVIDED`+ x t / \ YE NO YES NOill, NO NARKING Ni QUIPI.I) 10Ie,L ()MLSIAYUSESON-APCL_ Dwelling 2 Number of Guest Rooms + 3p Total Off-Street Parking i 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 OFONNE / LISANT DATE PRINT iJAME V%) CAS TR-ZL1.--- DAYTIME PHONE NUMBEP 14�jy ("nal 66\3 O 7j0- (2lS5910 Approved[ ] Approved with Conditions [ ] Denied•[ ] Zoning Official. Date* VDH Approval Date Building Official Approval Date. Fire Marshal Approval Date. Conditions: SUBMIT THIS PAGE,YOUR SKETCH, YOUR VDH APPROVAL (IF REQUIRED) ,AND YOUR $158 APPLICATION FEE TO COMMUNITY DEVELOPMENT,401 MCINTIRE ROAD, CHARLOTTESVILLE,VA 22902 www.albemarle.org/homestays v.9/17/19 I Page 5 of 13 JlirI ( Provide Sketch Here or Attach Sketch to This Application rOoovk rcirr7?(--- f?vo M 41 3 62cQrocmcs ,t gy. !NN. � 1 C(1 www.a1bemarle.org/homestays v.9/17/19 I Page 6 of 13 • ,•OF AC.S. Albemarle County. Commuopment `-` Short-Term Rental Registry � 401McnitireRd. orthWi �� ;, 401 McIntire Rd.North Wing Charlottesville,VA 22902 Annual Application \ ' tr Phone 434 296 5832 www.albemarle.org Prior to opening for business,all operators of short-term rentals(including homestays 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 zoning clearance(requires VDH and building/fire safety inspection) • Register for a business 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 business license and remit reauired taxes Fields marked with an'asterisk are the minimum required for registration. 1.Short-Term Rental Information A whole house 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+acres. `APPROVED HOMESTAY(HS),BED AND BREAKFAST(BNB),OR ACCESSORY TOURIST LODGING(ATL)CLEARANCE PERMIT NUMBER(IF APPLICABLE): (2 5; 11 O©I OO 12 OO 'ADDRESS: o t�1 ���LA 'CITY,STATE,ZIP: C70- VA 210t3 Z- TAX MAP PARCEL(IF KNOWN): ,2: LOT 6 r1k1t [ ZONING(IF KNOWN): /" l l A no, �R GUEST BEDROOMS: WHOLE HOUSE RENTAL: ❑YES NO 2.Property Owner/Operator Information *NAME: r►J C4 - LL'5e 'HOME ADDRESS: i l�Y�.0NCA) 1ZVA c' q 'CITY,STATE,ZIP: CH t-. t� �(1 L --E , VA 2'Z l o PHONE: Geri Y I CI) 1S 0 EMAIL: 1Zv4LA0 V' 3► lJ 1/4 eG ‘/1 3.Responsible Agent Information 1� 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. OWNER/OPERATOR IS RESPONSIBLE AGENT: 4S 0 NO IF NO,COMPLETE RESPONSIBLE AGENT INFORMATION BELOW NAME: t�,l CANIE�L HOME ADDRESS: L � -Ge�E t. '1 ST— CITY,STATE,ZIP: C ro �. \ /� 2zM�Z z , 2` PHONE: 77Q3 CbG SQ 110 EMAIL: el4mI� 1 J. 4 1Y p., 1. cowl FOR OFFICE USE ONLY Date Paid: 0❑Accepted ❑ Hied Fee Amt: ❑$27 0$0 with clearance application Ck#: Reviewed by: Receipt#: Received by: Registration Date:_/ www.albemarle.org/homestays v.9.17 20 I Page 1 of 1