HomeMy WebLinkAboutHS202000021 Approval - County 2022-06-17Homestay
Zoning Clearance
FOR OFFICE USE ONLY
Fee Amt: $158
Receipt #: P-o-?- j a
1. Applicant/Owner Information
NAME:
E-MAIL ADDRESS: L. lA Cy t+SO ;
MAILINGADDRESS: v OI
2. Homestay Information
TAXMAPANDPARCEL NUMBER C
(ORADDRESS, IFUNKNOWN), c
ZONING: ACREAGE:
rK,�a I pt
RESPONSIBLE AGENT NAME:
to
RESPONSIBLE AGENT EMAIL:
RESPONSIBLE AGENT ADDRESS:
3. Verification of Requirements
NUMBER OF GUEST BEDROOMS:
PARKING REQUIRED:
Dwelling 2
Number&Guest Rooms +34-
Total Off -Street Parking H
APPROVED
by the Albemar Albemarle county
Community DeveQrSlllunityDevelopment
Date J % mire Rd., North Wing
Charlottesville, VA 22902
`I]e Phone 434.296,58321 Fax 434.972.4126
Date Paid:
Ck# 07_/1
1
�'C��
USING ACCESSORY STRUCTURES?
YES f NO
TOTAL HOMESTAY USES ON PARCEL
PHONE:
HOMESTAY NAME:
By: i'q �C�cs�}cCr
By:
.f3a-7
n Jq *zwc &a- Gol curl H-i
SAME AS ABOVE (OWNER)
RESPONSIBLE AGENT PHONE:
2 FO21SFROO1` OF RESIDENCY PROVIDED? I FLOOR PLAN -SKETCH PROVIDED?
YES j NO
NO
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 ahlrlc h , fk. ,
Zoning Off iciab
T Rz Approved [� Appr d with Conditions [ ] Denied[ ]
Date: (Z� '✓[,�(,/)
VDH Approval Date: Building Official Approval Date: Fire Marshal Approval Date:
Conditions
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 1 Page 5 of 13
fW5