HomeMy WebLinkAboutHS202000029 Application 2022-04-28DocuSign Envelope ID: 464B9C5E-9297-4492-A790-DClDODD54AA6
Albemarle County
• p= Community Development
Short -Term Rental Registry Charlottesville,
McIntire Rd. VA 229Wing
Charlottesville, VA 22902
Phone 434.296.5832
Annual Application R ,N•P 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 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:
895 Haden Lane
'CITY, STATE, ZIP:
Crozet, VA 22932
TAX MAP PARCEL (IF KNOWN):
Crozet, vA 22932
ZONING (IF KNOWN):
R2 Residential
GUESTBEDROOMS:
2
WHOLE HOUSE RENTAL:
❑YES IXNO
2. Property Owner/Operator Information
'NAME:
Dawn Cromer
'HOMEADDRESS:
895 Haden Lane
'CITY, STATE, ZIP:
Crozet, VA 22932
PHONE:
434-466-6942
EMAIL
cromer.dawn@gmail.com
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.
OWNER/OPERATOR IS RESPONSIBLE AGENT:
KI YES ONO IF NO, COMPLETE RESPONSIBLE AG ENT INFORMATION BELOW
NAME:
HOMEADDRESS:
CITY, STATE, ZIP:
PHONE:
EMAIL
FOR OFFICE USE ONLY
Date Paid:
Fee Amt 0$27 0$0 with clearance application Ck#:
Receipt#:
Received by:
❑ Accepted ❑ Denied
Registration Date: .. J__/_
www.albemarle.org/homestays v. 9.17.20 1 Page 1 of 1