HomeMy WebLinkAboutHS202200003 Application 2022-08-25Homestay
Zoning Clearance Application
Submit this completed application with the following online or to the address above:
Albemarle County
-li a Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
��nx:lril^r Phone 434.296.58321 Fax 434.972,4126
Application fee: $173.76
APPlkalion$11947eN I.gy Surcharge$4.76+Imi>erlion$50
1. Floor plan/property sketch with labeled structures used for the homestay, guest bedrooms, owner's bedroom, outdoor lighting
and signage for the homestay, labeled setbacks, and parking (minimum 2+ 1 spot/guest bedroom).
2. Copies of two forms of verification of residency (one government issued with photo I D+ one listing the address -acceptable forms
include driver's license, voter registration card, U.S. passport, others as approved by the Zoning Administrator)
1. Homestay Information
Residentiollyzoned and ruml area parcels of less than 5 acres may have 2guest bedrooms by -right. Use of accessorystructures (if built beforeAugust 7, 2019) is
oniypermitted byright m mral ama parcels of S+ants. Whole house rental isonty permittedon rural area parcels of 5+acres.
ADDRESS
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CITY. STATE, ZIP:
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TAX MAP PARCEL OF KNOWN):
ZONINGfl'KNOWN):
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ADVER'ISFD NAME OF FIOMES'rAY (IT APPLICABLE):
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ACREAGE OF PARCEL:
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NO. or GUEST BEDROOMS:
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USING ACCESSORY STRUCTURES?
❑ YES Q�\p WHOLE HOUSE RENTAL?
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2. Property Owner/Operator Information
,NAME: -_
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H 0ME ADDRESS:
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CITY. STATE, ZIP:
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PI ZONE NUMBER:
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EMAIL:
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3. Responsible Agent Information
The responsible agent must beavailable within 30 milesof the homestay at aft times during a homestay use. and must respond andattemptingood faith to
resolve any complaints within 60 minutes of being contacted.
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HOME ADDRESS:
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P IONE NUMBER:
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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 1 understand them, and that I will abide by them.
SIGNATURE:
Fee Nnt:: SSs69. 4% Date PaiajJ zWI zz,. _
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Recewedd by:
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oATE: I rJ6 �Xf1 A) 2eT2 Z-
FOR OFFICE USE ONLY
Saleiv imi ecHun date: _`_ Pas:, ❑Fail Zrxi inspecrat tla[e; _.µ_
6,1 Fo cl Service (if necessa,yk13Floonllan [3 Pawing
Noter
Reviawd By.
Dare:
❑Pa% 01ail
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E] Approved (] Denied
Short -Term Rental Registry
Annual Application
2c+°t �efr� Albemarle County
c > Community Development
° 401 McIntire Rd. North Wing
Charlottesville, VA 22902
(,f Phone 434.296.5832
�rRaN�P www.albemarle.org
Prior to opening for business, all operators of short-term rentals (including homestays and previously approved bed and breakfasts and
accessory tourist lodging rentals) must:
• Enroll on the Short -Term Rentals Registry with this form
• Obtain an approved zoning clearance (requires VDH and building/fire safety inspection)
• Registerfora business license and remit required taxes
Annually following the initial approvals, all operators of short-term rentals must:
• Renew their enrollment on the registry with this form
• Pass a fire safety inspection
• Renew their business license and remit reouired taxes
Fields marked with an 'asterisk are the minimum required for registration
1.Short-Term Rental Information
A whole house rental is a short term rental of a home during which the owner is not required to be present. Whole house rentals are only permitted on Rural
Area parcels of 5+acres.
'APPROVED HOMESTAY (HIS), BED AND BREAKFAST (BNB), OR ACCESSORY
TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER (IF APPLICABLE):
'ADDRESS:
496R Burnley Lane
'CITY, STATE, ZIP:
Barboursville, VA 22923
TAX MAP PARCEL (IF KNOWN):
02200-00-00-02600
ZONING (IF KNOWN):
agricultural
GUESTBEDROOMS:
2
WHOLE HOUSE RENTAL:
❑YES IN NO
2. Property Owner/Operator Information
'NAME:
Christina Saylor
'HOMEADDRESS:
4968 Burnley Lane
'CITY, STATE, ZIP:
Barboursville, VA 22923
PHONE:
727-288-6586
EMAIL
moonfirefarmVA@gmail.com
3. Responsible Agent Information
The responsible agent must be available within 3P miles of the homestay at all times during a homestay use, and must respond and attempt in good faith to
resolve any complaints within 60 minutes of being contacted.
OWNER/OPERATOR IS RESPONSIBLE AGENT:
OYES ❑NO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
ME:
Stuart Saylor
ADDRESS;
4968 BUrnIEy Lane
CITY,STATE,ZIP:
Barboursville, VA 22923 -
PHONE:
727-373-8178
EMAIL
moonfirefarmVA@gmail.com
FOR OFFICE USE ONLY Date Paid:
Fee Amt: ❑$27 0$0 with clearance application Ck#:
Receipt#: Received by:
❑ Accepted ❑ Denied
Reviewed bv:
Registration Date:
www.albemarle.org/homestays v. 9.17.20 1 Page 1 of I
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