HomeMy WebLinkAboutHS201900009 Application 2022-06-13Homestay
Zoning Clearance
FOR OFFICE USE ONLY
Fee Amt: $158
Receipt #:119�- -
1. Applicant/Owner Information
2. Homestay Information
APPROVED
b the Albemarle County
y oee� Albemarle County
Community Development Depart Community Development
Date l2 22- 401 McIntire Rd., North Wing
Charlottesville, VA22902
File ,�, ,r>mvia Phone 434.296.58321 Fax 434.972.4126
TAX MAP AND
(OR ADDRESS,PARCEL IF UNKNOWN)ER
0W-00'
ZONING:
ACREAGE
HOMESTAYNAME.
RESPONSIBLE AGENT NAME
ME AS ABOVE(OWNER)
RESPONSIBLE AGENT EMAIL.
RESPONSIBLE AGENT PHONE:
RESPONSIBLE AGENT ADDRESS:
3. Verification of Requirements
NU M HER OF GUES`T1 BEDROOMS
USING ACCESSORY STRUCTURES? SIDENCYPROVIDED?
FLOOR SKETCH PROVIDED?
_PROD
YES NO °ES NO
YES NO
PARK REQUIRED: EG RNI PARKING
4TOTAL HOMESTAY USES ON PARCEL
�I
owxlrng 2
I
Numberof Guezt Raoms +�
Total Off -Street Parking
4. Applicant Signature
I hereby apply for approval to conduct the Homestay identified above, and certify that this address is my legal residence. I also certify that I have
read the restrictions on Homestays, that I understand them, and that I will abide by them.
DATE:
PRINT NAMES
DAYTIME PHONE NUMBER
ao.S�
Approve Approved with Conditions [ IDenied[ I
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Zoning Official:
Date: t7 2j 4)
VDH Approval Date:
Building Official Approval Date: Fire Marshal Approval Date:
Conditions:
SUBMIT ONLY THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL, AND YOUR $158 APPLICATION FEE
www.albemarie.org/development/ v. 8/14/191 Page 5of6
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APPLICATION FOR A SPECIAL EXCEPTION
N5 uiq - cq
`C Request for a waiver, modification, variation ❑ Variation to a previously approved Planned
or substitution permitted by Chapter 18 = $457 Development rezoning application plan or
Code of Development = $457
❑ Relie! fro n a condition of approval = $457
Provide the following
❑ 3 copies & a written request specifying the
section o. -ections being requested to be
waived, modified, varied or substituted, and
any other exhibit documents stating the
reasons for the request and addressing the
applicable findings of the section authorized
to be waived, modified, varied or substituted.
Project Name :
.G
Provide the following
❑ 3 copies of the existing approved plan
illustrating the area where the change is
requested or the applicable section(s) or
the Code of Development. Provide a
graphic representation of the requested
change.
❑ 1 copy of a written request specifying the
provision of the plan, code or standard for
which the variation is sought, and state the
reason for the requested variation.
Current Assigned Application Number (SDP, SP or ZMA)
Tax map and parcel(s):
Applicant / Contact Person
C
�
Address Li C> 1 U Y 1n. t City --5a Y 06-%6 V'3ta e —Vi�i—p �
Daytime Phone# (S oEmail
Owner of Record f /
Address l t� i 01 &� City }� 1 ( JV J State "AZip��2�
Daytime Phone# ( ) Fax# ( ) Email
County of Albemarle C
Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 972-4126 A