HomeMy WebLinkAboutHS202200003 Permit 2022-10-05APPROVED
by the Albemarle County
Community Development Department
HomestayDate � ; Albemarle County
-- //.,li Community Development
---1` 401 McIntire Rd., North lying
Zoning Clearance Application Charlottesville, VA 22902
Phone 434.296.5832 I Fax 434.9724126
Application fee: $173.76
Submit this completed application with the following online or to the address above: AWk.tia, suv. TK -kw su/clsvp a176•ImpMion$So
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 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
RC identiallyzoned andrural area parcels of less than S acres may haw 28wst bedrooms by -right. Use of a ccessorystructures (if built before August 7. 2019) is
ontyPermidedby right on rural area parcels of s+acres. Whole house rental is onbpennittedon coral area parcels of 5+acresAD 55
CITY. STAIt, ZIP. .3414`, _rev., ?757 i
TAX MAP PARCEL ilF KNOWN):
ZONING(IF KNOWN): I";/r„(
ADVERTISEDNAMf: OF HOMEStAY ill APPLIV.610: `xl:eyµ„/,x Ll7r 1.•` ipl.. C'lrL•..+: ACREAGE OF PARCEL' -
7
NO.OF GUEST BEDROOMS: -+ u51WG ACC ESSORYSTRUCrURES? ❑yf W1111, HOUSE REN TAL,
2. Property Owner/Operator Information
`NAMC -
Ili/S-
HOMF ADDRESS+ c 6 //
CITY. STATE. 21R h J%;,fu -1✓,F4 I;A 22ti2 5
PIJONE NUMBER: L 7; t2.'? G' Si (• EMAIL' 11 j�.•n'r n• �.H r�sV f{ .>i
3. Responsible Agent Information
The responsibleagent must beavailable within 30 miles of the homestoyat aft times during o homestay use. and must respond and attempt ingood faith to
resolve any complaints within 60minutes of beins contacted.
ALA•-'F:
NOME ADDRESS:
cl ry.5-iATE. Zip.
PI IONS NUMDEG
I MAIL: . sk ti..l%--."
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 1 will abide by them.
-. ._.--- -
DATF: A) lkri Z
7 ; 7? !�l7t'5
11 FOR OFFICE USE ONLY
I'e!•Porx: 5269.4Y• Dale 1'oini_I2181'L'L SafNY in>nection adb: /_Z Z.
as ❑Fail Axi insPni-vn date: _ � Ps• Q I ai
RtY C,OITT/1�b�plf6w_5(�ppT _ p•I Fr»a Service lip necessaryi r., ��... ffrrrMIALW
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T�tnit'Ile Sum — — Wm16y
Rer.rmaby. ►nets Dune: y'-23-ZZ_ --
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.__--- ------ ICI AUpreved Denied
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