HomeMy WebLinkAboutHS202200027 Application 2022-06-01 ��o�,k14%, Albemarle County
Homestay ,;�'� Community Development
z ®__�l 401 McIntire Rd.,North Wing
'R 7t' Charlottesville,VA 22902
Zoning Clearance Application �l'ri;irv' Phone 434.296.58321 Fax 434.9T2.4126
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. . • t •
ADDRESS: 1509 Ricky Road
CITY,STATE,ZIP: Charlottesville, Virginia 22901
TAX MAP PARCEL(IF KNOWN): 061 KOO8OAOO1 00 ZONING(IF KNOWN): R-4
Residential
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE): Ricky Road Retreat ACREAGE OF PARCEL: 0.22
NO.OF GUEST BEDROOMS: One USING ACCESSORY STRUCTURES? ❑ I NC) WHOLE HOUSE RENTAL? ❑YES )(NO
2.Property Owner/Operator Information
NAME: Sharon Torzala
HOME ADDRESS: 1509 Ricky Road
CITY,STATE,ZIP: Charlottesville, Virginia 22901
PHONE NUMBER: 414-403-7139 1 "v'' gbwashington8@aol.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. •
NAME: Sharon Torzala
HOME ADDRESS: 1 509 Ricky Road
CITY,STATE,ZIP:
PHONE NUMBER: Charlottesville, Virginia 2 901
414-403-7139- gbwashingtoa8@ao_Lcom
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.
SIGNATURE: kv101 J6i7 DATE: 6/1/2022
I) FOR OFFICE USE ONLY
Fee Amt:$169+4% Date Paid: 1a42 Safety inspection date• _ ❑Pass ❑Fail 2nd inspection date: _ 0 Pass ❑Fail
Receipt#C,C. • _ VDH Food Service(if necessary): ❑Floorplan 0 Parking 0 ID
Ck#: Notes: Reviewd By:
Received by: DO Ili tut 5 Date:
Hs# 20d, ` DOOa) ❑ Approved Denied
14 5 2OZLd O3O ��
04 LEGEND ' .
BATHROOM LAUNDRY KITCHENETTE A Fire Extinguisher
Exit
HStairs
0 ----- I Window
7
Main Water Line
No
EXIT Emergency Phone Numbers
----\-. a
_' Albemarle Fire Dept.
(434)296-5833
pi Albemarle Police Dept.
.Y
�,,J (434)977-9041
it `l' 911
No w LIVING ROOM
BEDROOM 0
EXIT < AREA O NO FIREARMS
O ALLOWED ON PROPERTY
-
1-
mr- O NO SMOKING
ALLOWED ON PROPERTY
I 1111111MINI ,C)
NO ILLEGAL DRUGS
4, ALLOWEDED ON ON PROPERTY
1509 Ricky Road, Charlottesville, VA 22901
Driveway for
2
parked guest
cars
KICKY ROAD