HomeMy WebLinkAboutSE202200009 Plan - Approved 2022-08-25Homestay
Zoning Clearance Application
Albemarle County
Community Development
401 McIntire Rd, North Wing
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Charlottesville, VA 22902
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Phone 434.296,58321 Fax 434.972.4126
Application fee: $173.76
Submit this completed application with the following rwvncauanEus-rnnnolucys„rm,rgeE74+m+Pedwnaso
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)
I. Homestay Information
Residentially zoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by -right. Use of accessory structures (if built before August 7, 2019) is
onlypermitted by -right on coral area parcels of 5+acres. Whole house rental is onlypermitted on rural area parcels of 5+acres.
ADDRESS
CITY, STATE. ZIP
Cr,CIZ-R. ,t
!E
`%
2 l
J!.
TAX MAP PARCEL (IF KNOWN)
/1 _ O I _ U /
C) 3 %f U al Ts ZONING (IF KNOWN).
I�
ADVERTISED NAME OF HOMESTAY (IF APPPLLICABLEI
i
ACREAGE OF PARCEL:
3 b
NO. OF GUEST BEDROOMS:
l
USING ACCESSORY STRUCTURES
rE5 ❑ NO
WHOLE HOUSE RENTAL?
❑ YES I>
2. Property Owner/Operator Information
NAME GhnZ P k-
HOME ADDRESS Ji [/• v` ^ I ^
C17V. STATE.DP
-
PHONE NUMBER: --�1 yh—�'767 EMAIL l L
_%IOS.1��DiS�t�tw�(�,L-On1..
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay at all times during a homestay use, and must resoondpndattepipt in good faith to
resolve any complaints within 60 minutes of being contacted. FlF'F'rilJC''t'U
byAltIP.R4'iflP f:nllnf _
NAME. r1S ? 1.n Cw munity Development Department
HOME ADDRESS 11�3Date
j S� - -
File
CITY, STATE. ZIP.. CC Z <, U/ `Z3
PHONE NUMBER: ` !)_ l L. - .?aq`✓27 _� -EMAIL
-- .. -.� �rimtA: I • Ll1M
4.Signature
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 1 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 Oem, and that I will abide by them
SIGNATURE _� (..� ---. __-.DATE
An3,(P FOR OFFICE USE ONLY
q Z-5-ZZ
Fee Amt S169 , 44% Date Paid: _lint Safety mspecnon date.: �2� Pass�Fait
"'
Irr'"e
2nd inspection date:
t �j - vx's,
❑ Fail
Receipt 0 (.��K y/�� I� VDH Food Service If necessary)
14Flowpian
Parking ID
Ckx- M I R _1..-•l! • � NMes, �VprJ b["C �bj ff. re�A.._.
Reviewd By.
Received by:[�.�- _
Date:
I 5 " -—�—
❑ Approved
E] Denied
v�
.v<or "reEH Albemarle County
• Community Development
Short -Term Rental Registry �'_ 401 Charlottesville,
North Wing
Charlottesville, VA 22902
Annual Application h F wwnalbern96.ort;
eclx www.albemarle.or
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)
• Registerfor a business license and remit renuired 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 required taxes
Fields marked with an'astensk 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(HSI. BED AND BREAKFAST (ENE), OR ACCESSORY I ��
TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER (IF APPLICABLE):
'ADDRESS: ID 1 1
'CITY, STATE, ZIP: Grp f
TAX MAP PARCEL (IF KNOWN): I OS6A I _U l _ 03')O ZONING (IF KNOWN):
GUEST BEDROOMS: I. WHOLE HOUSE RENTAL: I OYES 0<0 ,
2. Property Owner/Operator Information
`NAME:
ft' 7 ft'C( J ' 1�lvr� 11 PIC9v. f1 y 4(CQ..t
'HOMEADDRESS:
'CITY, STATE, ZIP:
C. r 07 „J\}V%A3]
PHONE:
1—q,��_LL121—..._._ EMAIL• �Y"iC �S�U�4/�ttf� [dm
3. Responsible Agent Information
The responsible agent must be available within 3Q 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,.
gr<[S ❑NO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOME ADDRESS:
CITY, STATE, ZIP:
PHONE:
EMAIL:
FOR OFFICE USE ONLY
Fee Amk 0$27
Receipt Y:_
O)ykwith clearame application
Date
Ck 9:
Received by:
IB7 Ccepted ❑ Denied
Reviewed
Registration Date: _I—J—
www.albemarle orglhomestays v. 9.17201 Page 1 of 1
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