HomeMy WebLinkAboutHS202100051 Approval - County 2022-02-16 APPROVED OF A(� Albemarle County
b th marle / 1 Community Development
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• I� 401 McIntire Rd.North Wing
Short-Term Trent ���^ Charlottesville.VA 22902
ate Z^I : Phone434.296.5832
Annual Application File 6�?7 ______ �1RGL$ � 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 zoniii'c lear,ance(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 L
TOURIST LODGING(ATL)CLEARANCE PERMIT NUMBER(IF APPLICABLE): 1 l
'ADDRESS: 'D
'CITY,STATE,ZIP: Ckf 41.Lo-Ties\/ 1 ko-€ V A- 2.2 ct CO /.
TAX MAP PARCEL(IF KNOWN): ZONING(IF KNOWN):
GUEST BEDROOMS: WHOLE HOUSE RENTAL: ❑YES 0 NO
2.Property Owner/Operator
-I Information
•NAME: �/�3° , ���' 19r+' � IhJ ( �/r 1?-'FS
'HOME ADDRESS: ( d I WA'1 A, 4 t
'CITY,STATE,ZIP: C f-(k v VA— c2a-dle l
PHONE: r ( 5L / 2
. 1 0,14 -� 3 ��_EMAIL: G I G G /r/�! 6,14 I A CE. O '-1
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: r-H YJES ❑NO IF NO,COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOME ADDRESS:
CITY,STATE,ZIP.
PHONE: EMAIL:
FOR OFFICE USE ONLY Date Paid: / / laKeCepted 0 Denied
Fee Amt: ❑$27 �$0 with clearance application Ck#:
Reviewed by:
Receipt#:_.. Received by: Registration Date: Zi /4 -2.6Z2
I-1Si0Zi DES
www.albemarle.org/homestays v.9.17.20I Page 1 of 1
APPROVED
by the Albemarle County or,,, Albemarle County
Homesta gommunity Deve pm nt D part ,ti ! ', CommunitevelopmentY at@ ` ��r2 �aa " 401 McIntire Rd.,North Wing
Charlottesville,VA 22902
Zoning Clearance ApFp _'--- -.._- „cn ' Phone434.296.5832IFax434.972.4126
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.(J/ADDRESS: /0/ i �- .�
CITY,STATE,ZIP: wwwC`//9 Z-c7-7-7-z V a A
TAX MAP PARCEL(IF KNOWN): ZONING(IF KNOWN):
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE): t A-g/ Pi- +19• VI ACREAGE OF PARCEL:
NO.OF GUEST BEDROOMS: USING ACCESSORY STRUCTURES? YES 0 NO WHOLE HOUSE RENTAL? ❑YES NO
�j•CG
2.Property Owner/Oper r nformation�(�ti _
NAME: / YG_�J(� .� /G ,q d;/l..-‹* &ice/c
HOME ADDRESS: /O J v e t C -;
CITY,STATE,ZIP: /7.4 2--0 ,5 I ,/ J� V 2 2 90
/.
PHONE NUMBER: C aa —?-2 36 EMAIL:/j345- / C ,3 V' ,,, �C
� /
3.Responsible Agent Information a��,
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.acJ y� �'y} /NAME: � -A/l. // O ii/Mi/ 1 C_%G� 1 C '
HOME ADDRESS: 1///�) 3 I,(��,z_ /EL'� ��-i -
CITY,STATE,ZIP: r�// �Gl-�0 .7E� //, /u& j/� 2,) OJ..
PHONE NUMBER: /3/ 2& _/�y.� EMAIL:
/7,,e l�c o�/ 63M'� C c
4.Signature ( /c/ OC
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.
SIGNATURE: %/ j� - �!//_ DATE: /O 74Q4/
rJ C
FOR OFFICE USE ONLY
Fee Amt:$169+4% Date Paid: 14,
V!J J 24 Safety inspection datex-.I-2 ['Pass Fail 2nd inspection date: 2-14,-22 ItOt
/
�$J ❑Fail
Receipt#: Pit'2-1 VDH Food Service(if necessary): ` orpian ! ing ,J I O1D
Ck#: S Notes: Reviewd By: fi�i�� �T
Received by 1[l j� �7/Date: 6-Z Z
HS# 2.0Z10006 I 13.4proved 0 Denied
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