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HomeMy WebLinkAboutHS202100039 Application 2022-08-11Homestay Zoning Clearance Application Sub ' this completed application with the following online or to the address above: �y of Arai., Albemarle County `zy Community Development =] Po 401 McIntire Rd., North Wing Charlottesvil(e,VA22902 Phone 434.296.5832 1 Fax 434.972.4126 Application fee: $173.76 Application $119+T chnolo&Surcharge $4.76+ Inspection $5o VFloor plan/property sketch with labeled structures used for the homestay, guest bedrooms, owner's bedroom, outVortaihting nd signage for the homestay, labeled setbacks, and parking (minimum 2+1 spot/guest bedroom). Copies of two forms of verification of residency (one government issued with photo ID+one listing the address - ale forms VV include eddrive'slice0se,voter regis((,�,t,''TITt,�f�j����pp rr� trationcard,U.S.passport, others as approved by the Zoning Administrator) ,�^ I hhVV'--55 (dog) V b i i. l '/'!'rfiI`1 1. Homestay Information Residentiallyzoned and rural area parcels of less than 5 acres may have 2guest bedrooms by -right. Use of aaessorystructures (if built beforeAugust 7, 2019) is only permitted by -right on rural area parcels of S+arse$. Whole house rental is onlypermittedon rural area parcels of 5+acres. ADDRESS: lI2- Oak 64rs� ci.-de CITY, STATE, ZIP: Cy, Avlof'eSy/Ilt a 0I TAX MAP PARCEL (IF KNOWN): D - ^O ZONING (IF KNOWN): ADVERTISED NAME OF HOMESTAY(IF APPLICABLE): ACREAGE OF PARCEL: 0,y NO.OF GUEST BEDROOMS: I —USING ACCESSORY STRUCTURES? ❑ YES Iy u N0 WHOLE HOUSE RENTAL? ❑ YES KNO 2. Property Owner/Operator Information NAME: V QOi Z rr HOME ADDRESS: I I2 Oc,K c CITY, STATE, ZIP: . /Gtffc-I (hAf `oyes;YA Ile 1,)-AL PHONE NUMBER: 434 424, ow EMAIL: bOWIPS 3 n 3. Responsible Agent Information The responsible agent must be available within 30 miles of the homestayat all times duringa homestay use, and must respond and attempt in good faith to resolve onycomplaints within 60 minutes of being contacted. NAME: owof- Aboa HOME ADDRESS: V7YV CITY, STATE, ZIP: PHONE NUMBER: EMAIL: 4. Signature I hereby apply for approval to conduct the homestay identified above, and certify that this address is my legal residence, and that I own the property or that I have recieved a special exception to operate the homestay as a resident manager. I also certify that I have read the restrictions on homestays, that I understand them, Ind that I will abide by them. SIGNATURE: I f�xA - 1.1 - I DATE: I g . q , Zt Fee Amt$169+4%DatePaid: Receipt 4: 1-.1 j l o 6 V Ck#: '! G 7 Received r 7by: K, ZLxyiy HS4 '—Q1-1-0003A FOR OFFICE USE ONLY Safety inspection date: ❑ Pass ❑ Fail 2nd inspection date: VDH Food Service (if necessary): 0 Floorplan Notes: Reviewd By: Date: []Pass ❑Fail ❑ Parking ❑ ID ❑ Approved ❑ Denied I Z, Oo;k f;,/c4 G-c(e u , f N G" 0 zq�