HomeMy WebLinkAboutHS202200040 Application 2022-09-12Homestay
Zoning Clearance Application
AlbomaAa County
Community Development
M 401 McIntire Rd., North Wing
^' Charlottesville, VA 22902
Rhone 434.296,5832 I Few 434.972.4126
Application fee: $173.76
A0011[Mian $]SV s TerhnnlapYSw<M1eryc 53.7b • Imq: ""-'m 55C
Submit this completed application with the following Edir or to the address above:
bedrooms,owner'S bedroom: outdoor llghti�g
1. Floor plan/property sketch with labeled structures used for the homestay g e
and signage for the homestay, labeled setbacks, and parking (minimum 2 + 1 spot/guest bedroom).
2. Copies of two forms of verification of residency lone 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
Resider.coll yenned and mml area porcelsof iessthan 5 acres may have2grest bedrooms by -right Use ofaccessory structures (if built before August ?. 205 I is
onlycermlOodby-rimot on rural area parcels of 5+acres. Whole house rental isonly permitted on rural area parcels of5+acres.
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RTISM? NAA a OF HOMESrA)';Ir APPLCABIFPF GUE> HEr SOJMS. I USINGACCESSOkY 51 kUCTURES? ❑YES JANO -N/HOLE HOUSE RENAU eE',
❑ NO
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3. Responsible Agent Information
The responsible agent mustbeavoilable within 30 miles of the homestay at all times duringo homestay use, and must respond and attempt irgxd to rh :c
resolveany complcims within 60 minutes of beingecntacted,
M
NAME_
SltirYvQ CTh�
I-OMEAJDRESS:
CI -1: STATE ZIP:
Fd CNENUkT R
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 1 understand tlpm, and that I will abide by them.
9IG AII2L I 'I V.ttX C/1/�1`it��� I DATE: 19 I ILL
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Rece:led
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FOR OFFIC[ USE -ON' ry
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Date. _
Approved
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(] Denied -- --