HomeMy WebLinkAboutHS202000058 Application 2022-06-14Homestay
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1. Applicant/Owner Information
Albemarle Caunty
Community Development
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4O1 McinWe Rd.. North Wing
CharlottesviOe,0229B2
Phone 434.296.Sa32 I Fax 434972,4126
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3. Verification of Requirements
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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 1 have
read the restrictions on homestays, that I understand them, and that I will abide by them.
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Approved l 1 ,.. Approved with Conditions (j Denied ( I
Zoningofficiat Rate•
VDH Approval Date; ,Building Official Approval Date: 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.orgjhomestays V. IaMA1D291 Pap 5 of 13
Provide Sketch Here ar,4tfach Sketch to This Application
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v. 3106/20201 Page 6 of 23