HomeMy WebLinkAboutHS202100018 Approval - County 2022-08-26Homestay
Zoning Clearance Application
Albemarle County
;_; .,ii�, Community Development
401 McIntire Rd., North Wing
i •, f Charlottewille,VA22902
'a=S� Phone 434.296,5832 j Fax 434.972.4126
Submit this completed application with the following Qatim or to the address above:
Application fee: $158
1. Floor plan/propertysketch 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 ID +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
Residentiallyzoned and rural area ponce!, of les than 5 acres may have 2 guest bedrooms by -right. Use of accessorystructures (if built before August 7, 2019) is
onlypermitted try -right on rural area parcels of 5+acres. Whole house rental is onl ypermitted on rural area parcels of 5+acres.
ADDRESS: , 1r
CITY, STATE. ZIP. y ,.
TAX MAP PARCEL (IF KNOWN) �� ZONING (IF KNOWN):
ADVERTISED NAME OF HOMESTAY (IF APFLICABLE): ACREAGE OF PARCEL
NO. OF BEDROOMS: �.. USING ACCESSORY STRUCTURES? DYES ®NO WHOLE HOUSE RENTAL? ®yEs ®Nc
2. Property Owner/Operator Information
NAME'
HOME ADDRESS:
CITY, STATE, ZIP: -�
PHONENUMBER:
EMAIL
3. Responsible Agent Information rOl�
The responsible agent must be available within 30 miles of the homestayat all times during a homestay use, and must respond and attempt in good faith to
resolve anycompluints within 60 minutes of being contacted.
NAME
HOME ADDRESS:
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 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 1 understand them, and that I wilt abide by them.
SIGNATURE:' / y/++' r / --
f "rz DATE: l (l _t., i t i
FOR OFFICE-USE,OIJLY
nspeclion date Pa\sJ
Fee Amt $158 Date Paid: 51ob!.
Safety®Fail 2nd inspmbw date: 13 P IRFa-I
_
VUH Food Semm (if M•cessary): Floor
CKri:-
Pad<in ®ID
Notes:
Received bY:APPROVED
Re"dBy.
H s x _�G a — B
Date _ q =Z(�%7-
___ _ by the A1be
--,-----_ a�..!__ .._,na,• ®Approved ®Denied
Community DemoPment Department
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