HomeMy WebLinkAboutHS202200041 Application 2022-09-15 (3)Short -Term Rental Registry
Annual Application
Albemarle County
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Community D.I.Prnent
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401 McIntire Rd. North Wing
Charlottesville. VA 22902
Phone 4342965832
wwmalbemarleorg
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)
• Register for a business license and remit ren fired taxes
Annually following the initial approvals, all operators of short-term rentals must:
• Renew their enrollment on the registry with this form
• Pass afir 5ij&tvInspertion
• Renew their bM 5in ss lice rise andremit rep u it dtax s
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 Wholehotue rentois are only permitted on Rural
Area parcels of 5+ acres.
-APPROVED HOMESTAY (HS), BED AND BREAKFAST(BNB),OR ACCESSORY
TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER RF APPLICABLE):
'ADDRESS -
—_I-so 19 ro ad. 2 P-
'CITY, STATE, ZIP:
C1,igrl s v;1(M V a--D-W3
TAX MAP PARCEL(IFKNOWN):..
-+S0O—W-OO-OO-+BO
ZONING(IF KNOWN):
GUESTBEDROOMS:
I I
WHOLE HOUSE RENTAL •-.
DYES -1WNO
2. Property Owner/ODerator Information
'NAME
Mtir kIl3 L-LIVo
'HOMEADDRESS:
525 g 4O( r"f'/' a G—d-
'CITY,STATE.ZIP..
Chdrl Qs✓VAII -2-Z-1-903
PHONE
—�03 . g87 , -. Q (l 4 CI
EMAIL ;-
Y1'1 CL 14 @s 9 Yvt0. f I . COV V)
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay at all times during a hornestay use, and must respond and attempt in good faith to
resolve any complaints within 60 minutes of being contacted.
0OWNER/OPERATOR IS RESPONSIBLE AGENT:
YES ONO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOMEADDRESS:
CITY,STATE.Z)P.
PHONE:EMAIL
FOR OFFICE USE ONLY
FeeAmb 0$27
Receipt 0:
O $0 with clearance appllcatlon
wwwalbemarle.org/homestaYs
Date Paid:_J--/_
Received by:
O Accepted ❑ Denied
Reviewed bY'
Registration Date:
v.9.17.20 1 Pagel of l