HomeMy WebLinkAboutHO202200018 Application 2022-04-18 14020aa o0a
Homestay n�"r" Albemarle County
Community Development
1�®="TI 401 McIntire Rd.,North Wing
�' Charlottesville,VA 22902
Zoning Clearance Application 'ar t Phone 434.296.5832 Fax 434.972.4126
Application fee:$173.76
Submit this completed application with the following or to the address above: Application s119+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.
ADDRESS: '✓ � I(\[ glitt`o2eJ LAT..
CITY,STATE,ZIP: '�h/I� f`t/t2 ul'1l M
TAX MAP PARCEL(IF KNOWN): 6 800 —90 —60 D&jo A—a ZONING(IF KNOWN): —(5
{
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE). ACREAGE OF PARCEL: I
NO.OF GUEST BEDROOMS: 2._ USING ACCESSORY STRUCTURES? ❑YES ❑NO WHOLE HOUSE RENTAL? 0 YES ❑NO
2.Property Owner/Operator Information
NAME: ' Viet/4/ 1Z 4
HOME ADDRESS: �//j���s jj ogg/r url••
CITY,STATE,ZIP: Q't( L li iiJ l �'` v - 1YTT !//4U
PHONE NUMBER: td1 1 •66 ' EMAIL: � 6444G CY11
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: - ' Vkhil erVIN—Orq
HOME ADDRESS: 3L•'j� �1 sJ ' �cor ( - � J
CITY,STATE,ZIP: ( �{tII1/( — V 27//o g
PHONE NUMBER: t42 • qC;: � EMAIL: - iJI? •
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 I understand them,and that I will abide by them.
J
SIGNATURE:
FOR OFFICE USE ONLY
Fee Amt:$169+4% DaatttePatd: U 1 v<1 1 a�_ Safety inspection date: ❑Pass El Fail 2nd inspection date. ❑Pass ❑Fail
Receipt tr. Ia ) I 60 VDH Food Service(if necessary): ❑Floorplan 0 Parking 0 ID
Ck#: I�J� p ' Notes: Reviewd By:
Received by- Dan t f,I MC.S 5 Date:
H 5# ti O n. l't Approved Ei Denied
�y OF A y Albemarle County
• o� ' r Community Development
Short-Term Rental Registry =�� 401 McIntire Rd.North Wing
R� Charlottesville,VA 22902
Annual Application Phone 434.296.5832
1�Rcis'' www.albemarle.org
Prior to opening for business,all operators of short-term rentals(including 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 tire.5atety,
• Renew their business license Linn 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(HS),BED AND BREAKFAST(BNB),OR ACCESSORY
TOURIST LODGING(ATL)CLEARANCE PERMIT NUMBER(IF APPLICABLE):
`ADDRESS: ' I A,) 2 L O���5/ q�'
`CITY,STATE,ZIP: zl V/ i/� ,/ V I 1.ei4 : n(�"l�J Q
- 3
TAX MAP PARCEL(IF KNOWN): 06 00 D — V 0 ' 00 —O'i0. ONING(IF KNOWN): (Z ( RVS-j p.0'T)lir
GUEST BEDROOMS: 'J WHOLE HOUSE RENTAL: ❑YES ❑NO L+
2.Property Owner/Operator Information
*NAME: I/ .13 v2-01
'HOME ADDRESS: 35� t jiliCklikb1 (frAi.
'CITY,STATE,ZIP: C fit' o tL v4- 22ei0 3
PHONE: (/ I/- EMAIL: C, �J r rL - awl
3.Responsible Agent Information "� c/ ('
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.C
OWNER/OPERATOR IS RESPONSIBLE AGENT: gc'ES 0 NO IF NO,COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOME ADDRESS:
CITY,STATE,ZIP:
PHONE: EMAIL:
FOR OFFICE USE ONLY Date Paid: / / 0 Accepted 0 Denied
Fee Amt: ❑$27 ❑$0 with clearance application Ck#: Reviewed by:
Receipt#: Received by: Registration Date: / /
www.albemarle.org/homestays v.917.201 Page 1 of 1
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