HomeMy WebLinkAboutHS201900025 Action Letter 2022-07-07APPROVED
by the Albemarle County
Co7
Community Development Department
Date ZOZZ +'tN Albemarle County
HomestaF -- Community Development
Y 1' ^ 401 McIntire Rd., North Wing
Zoning Clearance '•� Charlottesville,VA22902
1 I>ghutE Phone 434.296.5832iFax 43II.972.4126
FOR OFFICE USE ONLY HS# "—��
Fee Amt: $158 Date Paid: 2 (cC q q I I
Receipt#:O Ck# q7
1. Applicant/Owner Information
NAME,
EMAILADDRESS _She tl Py.le.. CN D (.GEC PONE
MAILING ADOREGS. 9-1 x,, /1. I/ _ . _ 1 j�� -A _.- ler—It` /A
2. Homestay Information
TAX MAP AND PARCEL NUMBER n
f0-ADDRES5.'r UNKN0..1',
CONING. ACREAUL I.'] r10
RFSPDNSIBLE AGENT NAM�Ic
RESPONSIBLE AGENiEMAII ^ Gd�
RESPONSIBLf AGENT ADDRESS
3. Verification of Requirements i yyppCl -Y
NUNBFROf Gtn: ��-+M S: RcnRV STRURIIRFS?
PARKING REQUIRED 14AY USES DN PARCEL
2 _
Number of Guasl Roams ♦5 I
toMI0K51eee[ParNing
By: M� ✓
5A,'—a41-39 a5
aa.n ac _
tHUMLS.AV NAME:
- _- RESP(NSIBL� FAGCN'PMpNL
PROOF nr Rf SIPFNf Y FRnVIDF DI
C-
'A"[ A,
FIOORPIANSKFTCHPROv[DED?
110
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.
SIGNATURES OWNER/APPLICANT --
IIA'I: �6
I
, LL
PRINT NAME
DAY-IME PH, NE NUMBER.
—.M,_c he I be t — --
yt a 4 I 39a S
Approved �1 ' �ApF,pprloved with Conditions
Zoning Official: Il•Date: z'
VDH Approval Date: Building Official Approval Date: Fire Marshal Approval Date: _
Conditions:
Denied[ I
SUBMIT ONLY THIS PAGE, YOUR SKETCH, YOUR VDH APPROVAL, AND YOUR $158 APPLICATION FEE
www.albemarle.org/development,/ v. 8/14/191 Page 5 of