HomeMy WebLinkAboutHS202000024 Approval - County 2020-10-23Homestay
Zoning Clearance
FOR OFFICE USE ONLY
Fee Amt: $158II
Receipt #: (r0-73,3
1. Applicant/Owner Information
or A Albemarle County
Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
`�PfMaeY°'F Phone 434.296.5832 1 Fax 434.972.4126
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Date Paid: Z 2b By: ::I N Ll�
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NAME:
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E-MAILADDRESS:
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PHONE:
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MAILINGADDRESS:
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2. Homestay Information
TAX MAP AND (OR ADDRESS, PARCEL IF UNKNOWN):
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ZONING:
ACREAGE:
HOMESTAYNAME:
RESPONSIBLE AGENT NAME:
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SAME AS ABOVE (OWNER)
RESPONSIBLE AGENT EMAIL:
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RESPONSIBLE AAGpENT, PHONE:
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RES=ONSIBLEAGENT ADDRESS:
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3. Verification of Requirements
NUMBER OFGUEST BEDROOMS:
USINGACCESSORY STRUCTURES?
2 FORMS PROOF OF RESIDENCY PROVIDED?
FLOOR PLAN SKETCH PROVIDED?
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YES NO
YES NO
YES NO
dt 0
PARKING REQUIRED:
TOTAL HOMESTAY USES ON PARCEL
Dwelling 2
Number of Guest Rooms y
Total OR- 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.
SIGNAL WNE APPLICANT:
DATE:
PRI
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[ME PHONE NUMBER:
s mu .
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Elate p _ n partment
File
Approved [ Approved with Conditions [ ]
Zoning Official: Date: -It, - 25- 70
VDH Approval Date:
Conditions:
Building Official Approval Date:
Fire Marshal Approval Date:
Denied[ ]
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. 9/17/19 i Page 5 of 13
Street Parking (lot of spots]
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Tree