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HomeMy WebLinkAboutHS202000049 Approval - County 2022-06-14Homestay Zoning Clearance FOR OFFICE USE ONLY HS# Fee Amt: $158 Receipt#• ;-AS 5-7 1. Applicant/Owner Information Date Paid::�i1 )a�%1� - - By: 1 Ck# I 1ILI By: .a Albemarle County Community Development =]" 401 McIntire Rd., North Wing Charlottesville, VA 22902 il'+mme� Phone 434.296.58321 Fax 434.972.4126 NAMe Barry and Ellen Moss EMAILADDRESS: mossvineyards@gmail.com PHONE: 757.630.2893- MAILING ADDRESS: 1849 Simmons Gap Rd. 2. Homestay Information TAX MAP AND PARCEL NUMBER (OR ADDRESS, IF UNKNOWN): 00800-00-00-026BO ZONING: ACREAGE: HOMESfAYNAME: Rural 49.42 Moss Vineyards Guest Cottage RESPONSIBLE AGENT NAME: Barry Moss SAME AS ABOVE (OWNER) RESPONSIBLE AGENT EMAIL mossvineyards@gmail.Com - - RESPONSIBLEAGENT PHONE:- ]5].630.2893 .... - - RESPONSIBLE AGENT ADDRESS: 1849 .Simmons Gap Rd. 3. Verification of Requirements NUMBER OF GUESr BEDROOMS: USING ACCESSORY STRUCTURES? 2 FORMS PROOF OF RESIDENCY PROVIDED? FLOOR PLAN SKETCH PROVIDED? ® NO ® NO ® NO 2 PARKING REQUIRED: TOTAL HOMESTAY USES ON PARCEL Dwelling 2 One Numberof Guest Rooms } 2 - - - - - - - - - T.WOff-Street Na .g FAI 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 wilt abide by them. SI NATURE OFOW ER/APPLICANT: I DATE: LM 8/13/20 PRINT NAME: DAYTIME PHONE NUMBER: Barry and Ellen Moss 1757.630.2893 APPROVED by the Albemarle County Communiq Development Department Date I- D�6 proved [ I Approved with Conditions [ ] Denied [ File Zoning Official: D VDH Approval Date: Building Official Approval Date: Conditions: Fire Marshal Approval Date: SUBMIT THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL (IF REQUIRED) , AND YOUR $158 APPLICATION FEE TO COMMUNITY DEVELOPMENT, 401 MCINTIRE ROAD, CHARLOTTESVILLE, VA 22902 www.albemarle.org/homestays v. 3lW'=29I Page 5 of 13