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HomeMy WebLinkAboutHS202100018 Application 2022-06-03Homestay Zoning Clearance Application Albemarle County Community Development 401 McIntire Rd., North Wing Charlottesville, ' Charlottesville, VA 22902 Phone 434.296.5832 1 Fax434.972.4126 Submit this completed application with the following online or to the address above: 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 beforeAugust 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: 3760 CITY, STATE, ZIP: / l•, �' , /i ( z-ov/' TAX MAP PARCEL (IF KNOWN): / ADVERTISED NAME OF HOMESTAY(IFAPPLICABLE): ZONING (IF KNOWN): ACRE AGE OF PARCEL %'J3 NO. OF GUEST BEDROOMS: ,2 USING ACCESSORY STRUCTURES? ® YES ®NO WHOLE HOUSE RENTAL? ®YES ®NO 2. Property Owner/Operator Information NAME: !� D Z)-, rX a. HOMEADDRESS: CITY STATE, ZIP: !Ali ��rLc�'% i•`)'L C.-F�. ` PHONE NUMBER: L%j c�,.-. '.•;e�� f�lC�. EMAIL: %_1 1? r e . rr , r t. o^ • ad/ 3. Responsible Agent Information etot" 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: CITY, STATE, ZIP: PHONE NUMBER: EMAIL: 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 1 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: P' I 'i. DATE Fee Amt: $158 Date Paid: 5' -b I a, Receiptj#:: \-A ay.5-A r Ck#: _ kj(jCA- j �� r�� Received by: \(.&\-"0SN H S # FOR OFFICE USE ONLY Safety inspection date: ®Pass Oral 2nd inspection date: O pass ® Fail VDH Food Service (if necessary): ® Floorplan Notes: Reviewd ® Approved ® Parking ® ID -0 � �.�<°' " Albemarle County Short -Term Rental Registry x Community Development u Charlottesville, McIntire Rd. VA 229 Wing A/� /t � � Charlottesville,VA 22902 nnual Application Phone 434.296.5832 I%Aar�� 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: • Register with this form • Obtain an approved zoniniz clearance (requiresVDH 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 registration 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 rentat is a short term rental of a home during which the owner is not required to be present. Whole house rentalsare only permitted on Rural Area parcels of 5+ acres. 'APPROVED HOMESTAY (HS), BED AND BREAKFAST (ENE), OR ACCESSORY TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER (IF APPLICABLE): 'ADDRESS: C (l-_ ^,— rl 'CITY, STATE, ZIP: L.JN � Z TAX MAP PARCEL (IF KNOWN): ZONING (IF KNOWN): ✓ GUEST BEDROOMS: WHOLE HOUSE RENTAL: I YES ❑NO 2. Property Owner/Operator Information 'NAME: /'/;,A' !' `C. �Al..- .< !� -!r, 6k-lT-/t.. 'HOMEADDRESS: "CITY, STATE, ZIP: �q V� Z Z—e? ��--CC-- PHONE: lf, O/r /Z G�c OO .% EMAIL QIYL. 3. Responsible Agent Information The responsible aaggent 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 resolveanycomplaints within 60 minutes (being contacted. OWNER/OPERATOR IS RESPONSIBLE AGENT: ❑YES ONO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW NAME: A� V L HOME ADDRESS: CITY, STATE, ZIP: PHONE: EMAIL: FOR OFFICE USE ONLY Fee Amt: 0$27 14$0 with clearance application Receipt %: www.albemarle.org/homestays Date Paid:_ Ck M: Received by: ❑ Accepted ❑ Denied Reviewed by: Registration Date: _/_/_ V. 9.17.201 Page 1 of 1