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HomeMy WebLinkAboutHS202000036 Approval - County 2022-06-14tjHomestay Zoning Clearance FOR OFFICE USE ONLY Fee Amt: $158 Receipt#: P-0661(�- 1. Applicant/Owner Information V�J Albemarle County Community Development 401 McIntire Rd., North Wing it Charlottesville, VA 22902 Phone 434.296.5832 1 Fax 434.972.4126 �T. By: AWL I �S�-tyep�-tr. EMNEADDRESS: _ (1�'`t` r�%n�✓� V C*C49 Wto'ti 1 • ODYV-, PHONE: 1 1-1.2, y . qoq MAILRIGADDRESS. 3 (.Fp 3 {rt'1Bt✓l bhp ✓{-. , C YICL� 1oi4�S vi Il? . Vn.'LZfi c t 2. Homestay Information TAX MAP AND PARCEL NUMBER _ q (Olt ADDRESS, IF UNKNOWN): ZONING: ACREAGE: HOMESTAYNAME g i✓� efI vie, RESP OLE AGENT NAME: SAMEASABDVE( ER) RESPONSIBLEAGENT EMAIL AGENT AGENT PHONE: ,tiPONSIBLE AGENT ADDRESS: 3. Verification of Requirements NUMBER OF GUEST BEDROOMS: TUSRKr ACCESSOR, STRU(TUIiES? 2 FORMS PROOF OF RESIDENCY PROVIDED? FLOOR PLAN SIWTCH PROMLIED? _ I YES YE5 NO YE NO PAANING gEQVIRED: TOTAL HOMESTAY USESPNRARtEL ''OOxIFn{ 2ii NumEnd6ue#Raona ;L . TOW dFsawt A+„4 © `` �;(�CY�YiOpy1�I 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. APPROVED ,�,�'��� 5yttie Memarle COur&pproved� Approved with Conditions [ j Denied[ j Community Develo ment DeI Zoning OfflciaL VDH Approval Dat : dui L �rpyel Da--�.� Fire Marshal Approval Date: Conditions: SUBMIT THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL (IF REQUIRED), AND YOUR $158APPLICATION FEE TO COMMUNITY DEVELOPMENT, 401 MCINTIRE ROAD, CHARLOTTESVILLE, VA 22902 www.albemarle.org/homestays V. 9/17119 i Page 5 of LI