HomeMy WebLinkAboutSE202100014 Plan - Approved 2022-06-03Homestay
Zoning Clearance Application
Submit this completed application with the following or to the address above:
Albemarle County
Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296.5832 1 Fax 434.972.4126
Application fee: $158
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:
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CITY, STATE, ZIP:
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TAX MAP PARCEL (IF KNOWN):
1
ZONING (IF KNOWN):
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE):
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REAGE OF PARCEL:
NO. OF GUEST BEDROOMS:
I IUSING
ACCESSORY STRUCTURES?
IRI YES XNO
WHOLE HOUSE RENTAL?
® YES XNO
2. Property Owner/Operator Information
NAME:
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HOME ADDRESS:
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CITY, STATE, ZIP:
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PHONE NUMBER:
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EMAIL:
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3. Responsible Agent Information
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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:
HOME ADDRESS:
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CITY, STATE, ZIP:
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PHONE NUMBER:
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EMAIL:
4.Signature
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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:_ I h.1M L� I DATE: I *-//] / ! 2 02_k soal
Fee Amt $158 Date Paid. 1 I I
Receipt $:
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Received by:
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FOR OFFICE USE ONLY
Safety inspection date:1 2` Pass ® Fai
VDH Food Service (if necessary)`N Il A
Notes: ��7.\ —)�by ft Pill
2nd inspection date:
® Pass ® Fail
Floorplan
Parkin ID
Revie By:
�Date.
�QApproved
®Denied
File