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Home My WebLink AboutHS202200017 Application 2022-04-08 t� S 202200017 �.� • Albemarle County • Homestay �� IFIc'? Community Development ®�+• 401 McIntire Rd.,North Wing Zoning Clearance Application Or Pharlottesville,VA22902 a1� k, �' Phone 434.296.58321 Fax 434.972.4126 Application fee:$173.76 Submit this completed application with the following online or to the address above: Application$119+Technology Surcharge$4.76+Inspection$50 1. 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+1 spot/guest bedroom). 2. Copies of two forms of verification of residency(one government issued with photo ID+one listing the address-acceptable forms include driver's license,voter registration card,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. . O I c, 3r R pok d ADDRESS: I( O( ( P + //J� / �-\ CITY,STATE,ZIP: ahq r i V i I-e��'l ! le , V A 2�q c TAX MAP PARCEL(IF KNOWN): ZONING(IF KNOWN): ADVERTISED NAME OF HOMESTAY(IF APPLICABLE): N ! 1- ACREAGE OF PARCEL: 0. 23 NO.OF GUEST BEDROOMS: 1 USING ACCESSORY STRUCTURES? ❑YES XNO WHOLE HOUSE RENTAL? ❑YES ,NO 2.Property Owner/Operator Information NAME: R.A,sJ c.I I Oha LCl lrL1 ie t �L Y t I I 1 Y 1 HOME ADDRESS: I I -,('i)0 l ,I/ Ive Zit/ �/1 CITY,STATE.ZIP: !ur l ay t l/�` i-t S Il ICI K�-/ 1\��ll 2 2�0 I PHONE NUMBER: q to, - 2Z5 _ �� Uv V EMAIL. L VI u rerAa . j r i ff l 1i,16) 5-b- 235.202y { 3.Responsible Agent Information 1�1 OTl'11�I _CO 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: LQ uu-eta t 'r I f f I ' ,^ HOME ADDRESS: l (j 10 (Did I 1,DC)1 T t CITY,STATE,ZIP: l T 1l l o-t J V i 1J)- ��(�� 'ZVI LI 1 PHONE NUMBER: (Lq - 22S " �S i ( EMAIL: Laikrbi1GL 4.Signature L 1 JH U y1Gl► - (oh 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 special exception to operate the homestay as a resident manager.I also certify that I have read the restrictions on homestays,that I u rstand them,a " tat I will abide by them. • SIGNATURE: 1 j DATE p 3/ / a FOR OFFICE USE ONLY Fee Amt$169+4% Date Paid: Safety inspection date: ❑Pass ❑Fail 2nd inspection date: _ ❑Pass ❑Fail Receipt#: VDH Food Service(if necessary): ❑Floorplan ❑Parking ❑ID Ck#: Notes Reviewd By: Received by: Date: HS# ❑ Approved El Denied -- — _ .,-. , -. / - — Go..1.----k7—e ----1 11 0 \I T"tXV- To .1. „ ------- 13X_Y- - tiokilf,ss C!)'ell 'ei OC)•r 'Cl 00V 0 CA.1) I ---• 7 • s - 1 kIk-e-S i k.ot I te.s • ii °Al2.51A1 \rayt. 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A ' (--c.,A II• .‘ -,1c,o-- k Ckfrkeictn ow Ulta y loto i -to mai h Vl.ORNSI, i f I C , • I Ci'' ‘k\(/A kwo\1\4. i N L. 9r\ofo \ou'or--\ 1 \--‘ eHreirCQ( j_C--e-' CklarlOil-eS\li 'tie) VA 22-q01 , ' sr\N„ .\ \ \. 95- "Ebc 01\i.eStS "--, 1-10Me_ ONneV • y p‘,-1 one *.'s . r, _ PrOLVesc _ ----e.--- .1 b If 1pto • Albemarle County Community Development Z °ii 401 McIntire Rd.North Wing Short-Term Rental Registry J � � Charlottesville,VA22902 F Rhone434.296.5832 Annual Application I�ari9t% wwwalbemarleorg Prior to opening for business,all operators of short-term rentals(including honest an5 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 zgning clearance(requires VDH and building/fire safety inspection) • Register for a business license and remit required laic 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 required 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(H5),BED AND BREAKFAST(BNB).OR ACCESSORY TOURIST LODGING(ATL)CLEARANCERA PERMIT—{ NUMBER(IF APPLICABLE): 'ADDRESS: 1 �() )j�J /�— it,(a / 'CITY.STATE.ZIP: / l i 11QS V (sl f Vit. 2-(t] I/ ,TAX MAP PARCEL(IF KNOWN): ZONING(IF KNOWN): (GUEST BEDROOMS: WHOLE HOUSE RENTAL O YES *KO. 2.Property Owner/Operator Information "NAME: 'HOME ADDRESS: 2J( r 1/4 '(,( 1 'CITY,STATE.ZIP: Cs LNIN" la'fjc Vitj f k/� �2// I /� PHONE: /�G/�2-/ /�J�� EMAIL: V� j(N cI t7 S rCJYt• 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 minutes of being contacted. OWNER/OPERATORIS RESPONSIBLE AGENT: ❑YES O IF NO.COMPLETE RESPONSIBLE AGENT INFORMATION BELOW NAME. HOME ADDRESS: 2g3 3 o ,ln.-}- , CITY,STATE.ZIP: 0 ,Ul tC/A / / g/ PHONE ! _ !-41& FEMAIL: V/1' FOR OFFICE USE ONLY Date Paid: i / 0 Accepted 0 Denied Fee Amt. ❑$27 0 S0 with clearance application Ck p: Reviewed by: Receipt>r: Received by: Registration Date: / /_ www-albemarle.org/homestays v.9.17.201 Page 1 of 1 f • January 13, 2022 Page 3 f +w - ,�.-a:, Albemarle County ft Z Short-Term Rental Registry �� `."Zre"°ev`'°'7"" �►4 - : /'� i�_, utt rsunrwe R.a Nenn wry r• /"'-, CharNdteswlk,YA 22981 Annual Application '` Phone"4296Se" *my.ebernatte ore Prior to opening for business,at operators of short-term rentals(including fLArjeslia2 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 romnr clearance(requires VDH and building/fire safety inspection) • Register for a businerslirrnv gpd remit resulted to a: Annually following the initial approvals,all operators of short-term rentals must • Renew their enrollment on the registry with this form • Pass a fire ary Incnrctinn • Renew their business lice Meant/iemitreouiredtakes FeMS mark ea*Nm an`asterisk are the minimum regwrea tar retktratbft 1.Short-Term Rental Information Areaparesisd swlmie house home is a short term rental of a hoe stirring which the owner is not required to be present Whole house rentals are only permitted on Rural A acres. 'APPROVED HOMESTAY IN%BYO ANO BREAKFAST(BNB).OR ACCESSORY (� TOURIST LODGING(ATU CtEARANCE PERMIT NUMBER BF AMICABLE): `�(C, I f,LI I`�___i 'ADDRESS: '.>�833 13i t r'+ /Ail. 11 I "��77 rJ�w j U 'CITY,STATE.2tP. r Ls(1�-{-47c VI N.t F /� � ' TAX MAP PARCEL OF KNOWN,: / f ZONING{IF KNOWN) / ' GUEST BEDROOMS. ! _ i WHOLE HOUSE RENTAL ( ❑YES 3YFN0 2.Property Owner/Operator Information `NAME {(A(- `zOV..Li 'HOME ADDRESS. a,3/3 rm :11_ 'MYSTATE.ZIP. C#v.l 0� S�f,�Lb f VAT ��I ''^^ ��` �-y PHONE. y3Li.•�/9-' £ EMAIL _,_ Y7'._`l.l-as,:. .ts-. ✓h�4+ y 3.Responsible Agent Information The respmsRste rrNx whit t •pie the ornestay at all tines during a homestay us,,,arxt nut respond and attempt in good faith to resdve aor cord airtts d bung contacteai OWNEWONERATOR ISINSPONSBNE AGENT k.1.14 0 NO .INO.COMGLE dE Si SPONSIBLE AGENT INFORMATION BELOW NAME HOME ADDRESS: CITY,STATE,LIP. PHONE: EMAIL FOR Of f ICE USE ONLY 0Y•Y1t@:,___/-4_,„ Accepted 0 Denied Foe AtM- OS27 OZB Nthckareme application Ckk Reviewed by.. Rw(ptf: _ Racalred bit Regis*razes Date.__/_r./_.. mwmJleem see ms/haNecsires r 9.172W Page 1 of 1