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HomeMy WebLinkAboutHS202200026 Application 2022-06-09 Homestay �� ��, Albemarle County �y�l,; y� Community Development z c.Y®_�: 401 McIntire Rd.,North Wing '1' Charlottesville,VA 22902 Zoning Clearance Application �riRcih4 Phone 434.296.5832 I Fax 434.972.4126 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. ADDRESS: l 001 6f i J(s f�#(N,N y O. CITY,STATE,ZIP: r l et r JA' Z 7 Z.o TAX MAP PARCEL(IF KNOWN): 016Do-60'00- o13130 ZONING(IF KNOWN): gkitAt,sfi ADVERTISED NAME OF HOMESTAY(IF APPLICABLE): _/ ACREAGE OF PARCEL: 8•S'1 q NO.OF GUEST BEDROOMS: 2- USING ACCESSORY STRUCTURES? ❑YES 11Q NO WHOLE HOUSE RENTAL? El/YES 0 NO 2.Property Owner/Operator Information NAME: JMIC-F►gCL t-ITTt c>F�ei,p HOME ADDRESS: i- 01 SPg+t.* Vk 1120. CITY,STATE,ZIP: ietfli>4 Jk ZZg20 PHONE NUMBER: 5�(_3311-*12. 1 EMAIL: 016L3 X Q'ytitirt0llA. 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: lti1tGNPtG1, (mot 1�I l•EVD HOME ADDRESS: L too1 6 t J(r JA B I 0• CITY,STATE,ZIP: f ProtJ , Vk ' 2-0 PHONE NUMBER: s'i t -'334-725" EMAIL: Me xylft,(Tlr-hA.evLA. 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 excep ' to operate the homestay as a resident manager.I also certify that I have read the restrictions on homestays,that I un r d them,an at I will abide by them. SIGNATURE: DATE: FOR OFFICE USE ONLY Fee Amt:$169+4% Date Paid:✓/Z7`z� Safety inspection date: ❑Pass ❑Fail 2nd inspection date: 0 Pass ❑Fail Receipt#:C.C VDH Food Service(if necessary): 0 Floorplan ❑Parking ❑ID Ck#: 14 Pi Notes: Reviewd By: Received b . (�1J1X �JL4l1,1k/6 Date: HS# 1Lj5 9_ 6 02.(p Approved Denied ce '_1 ca'a Pace Analytical Services,LLC I il/`�'1 225 Industrial Park RD watMalsdsaa Beaver.VW 25513 (800)999-0105 ANALYTICAL RESULTS Project: ORD 5/17/22 Pace Project No.: 30489864 Sample: 4007 SPRING VALLEY Lab ID: 30489864001 Collected: 05/17/22 10:10 Received: 05/17/22 14:50 Matrix: Drinking Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qua! LBIO TCEC(P/A-18) Analytical Method•SM 9223B/Colilert 18 Preparation Method:SM 92238/Colilert 18 Pace Analytical Services-Lexington Total Conform ABSENT 1 05/17/22 16:15 OS/16/2210:15 E.coli ABSENT 1 05/17/22 16:15 05/18/22 10:15 REPORT OF LABORATORY ANALYSIS Date:05/19/2022 03:28 PM This report shall not be reproduced,except In full, without the written consent of Pace Analytical Services.LLC. Page 5 of 9 Photos 3D Contact Agent 1,).ne 511<m- 4 cf CAAR Contact Agent r Home Saved Share ri asat „�'4 tv WiA',Te .1 P 4 .5� Ai e d i I+ •••/'" RSA'97 '' V. ,ti ,:..n . -..__. x r 1 ,� Syr +';,� '/ - ' �13 ?,' 5 R (t, • ?'rR�� Ott.l5 � f`�"r pt'tirrs•�y IA ' �_� r ;, 1p _ f. •»�S '~ �'r, t 1'R�ps �Clit,. �r4)6# 1 i ?P r'Si '' ,, '? .` ' �A P-•e `,71f� Si • 3 f,1' �W ,, s�rtr ' '4,1r,r>$: n'1Fyy: ,y,41 . , f�. ',ri t t P: t . , _ . `7.1 •�y� �.r..''. r',' 't b F �Is-• . 4.,, l'l .. 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