HomeMy WebLinkAboutHS202000056 Application 2022-06-17Homestay
Zoning Clearance
FOR OFFICE USE ONLY
Fee Amt: $158 /
Receipt #: —/'M 1 I
1. Applicant/Owner Information
Date Paid: Lob,?
Ck#G�� 1
Albemarle County
->� Community Development
401 Mc ntire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296.5832 1 Fax 434.972.4126
By:�/��
NAME: k, Lr'-, . Mq•orr� 5
E-MAIL ADDRESS Fi 1'}k(/�'ly7o /'hy?� M`.L LC� P�HGNE LI3LI-LI��- 2IL
MAILING ADDRESS: 25VL IrO FF.,�' ✓ �► OM[5V IIG VA A O
2. Homestay Information , _ • n rl i_ n n _ nn , a n - n?- -At)
TAX MAP AND PARCEL NUMBED.
(OR ADDRESS, IF UNKNOWN):
2.S•�Z
YroFF. •� Rd
r t�
G(q,p,^.(p�'{'GSv'. ��G �%��
T.,i:q i(
ZONING:
ACREAGE:
NAME:
I aCKS F
.HOO,ME"STAY
J K GS �OKSG 0.I
WOO���trVL
RESPONSIBLE AGENT NAME:
DA�y�O
M.tT�S
SAME AS ABC:J E(CENERj
RESPONSIBLE. AGENT EMAIL:
U• btft�w...
l..}ySQ
/1a,',[O
RESPONSIBLE AGENT PHONE
[j�t(-1r66•-3 213
RESPONSIBLE AGENT ADDRESS-
3. Verification of Requirements
NUMBER OF GUEST BEDROOMS.
USING ACCESSORY STRUCTURES?
2 FORMS PROOF OF RESIDENCY PROVIDED?
FLOORPLANSKETCH PROVIDED?
A
IFS fJ:
YEc: NO
/Tco 1 N2
PARKING REQUIRED:
TOTAL HOMESTAY USES ON PARCEL
Duelling
2
Numb rof Guest Rooms
, I
/i
Total OR-Rree Parking
El:•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.
SIGNATURE OF OWNERIAPPUCANT:
DALE:
PONT NAME'.
DAYTIME PHONE NUMBER:
K�'4tritit M.t,.;
�13�t-�(%Cs-321
Approved [ ] Approved with Conditions [
Zoning Official: Date:
VDH Approval Date: Building Official Approval Date: Fire Marshal Approval Date:
Conditions:
Denied[ i
SUBMIT THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL (IF REQUIRED) , AND YOUR $158 APPLICATION
FEE TO COMMUNITY DEVELOPMENT, 401 MCINTIRE ROAD, CHARLOTTESVILLE, VA22902
wwwathemarle.org/homestays v. 340028 i PA(RS of 13
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