HomeMy WebLinkAboutHS202000034 Approval - Agencies 2022-06-14DocuSi n Envelope ID: 1AS24B2F-07A0.4C00.8EAO-D4703758E936
Homestay
Zoning Clearance
FOR OFFICE USE ONLY
Fee Amt: $1558
Receipt#: 1 Z-QS/6Z
1. Applicant/Owner Information
Date Paid: (5,
Ck# I� p
l I
ark, Albemarle County
Community Development
-f- 401 McIntire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296.5832 1 Fax 434.972.4126
By: Uy G
NAME
Mrs Jack Sanford
E-MAILADDRESS:
M san or aaci.com
PHONE,
4349065231
MAILINGADDRESS:
1319 ing erldge Farm Rd. Charlottesville,va 22901
2. Homestay Information
PA UNKNOWN ER
TAX MAP AND (OR ADDRESS
0�000O m �
�J
ZONING.
ACREAGE
HOMESTAYYNNAME.
JFW acres
to
ingleridge Farm Rd
RESPONSIBLE AGENT NAME
Mrs Jack Sanford
SAME AS ABOVE (OWN ER)
RESPONSIBLE AGENT EMAIL:
Mhsanford@aol.com
RESPONSIBLE AGENT PHONE:
1 4349065231
RESPONSIBLE AGENT ADDRESS
1319 ingleridge Farm
Rd. Charlottesville,va 22901
3. Verification of Requirements
NUMBER OF GUEST BEDROOMS:
USING ACCESSORY STRUCTURES?
PROOF OF RESIDENCY PROVIDED?
FLOOR PLAN SKETCH PROVIDED?
02
YES NO
X YES NO
YES X NO
PARKING REQUIRED:
TOTAL HOMESTAY USES ON PARCEL
Dwelling 2
Number of GuaA Rooms 42
Total OH -Sheet Parking
4. Applicant Signature
I hereby apply for approval to conduct the Homestay identified above, and certify thatthis 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.
SIGNATURE OF OWNER/APPLICANT-
DATE:
o ,
1 1 2019
essasae�arc4c^� ___-_
PRINT NAME:
DAYrIME PHONE NUMBER
Ann H san or
-
Zoning Official•_
VDH Approval Date:
Conditions:
Approved [ Approved with Conditions [ ]
Building Official Approval Date',L��®„�;,"Aire.Mprshal Approval Date:
Denied[ ]
SUBMIT ONLY THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL, AND YOUR $158 APPLICATION FEE
www.albemarle.org/development/ v. 8/14/19 1 Page 5 of 6
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