HomeMy WebLinkAboutHS202100026 Approval - County 2022-10-10riomestay
" -Zoning Clearance Application
Submit this completed application with the following online or to the address above:
Community Development
1 401 McIntire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296.58321 Fax 434.972.4126
Application fee: $158
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)
L Homestay Information
Residentfaltyzoned and rural area parcels of less than 5 acres may have 2guest bedrooms by -right Use of accessorystructurm (if built before August 7, 2019) is
onlypermitted by -right on rural area parcels of5+acres. Whole house rental is onl ypermitted on rural area porcels of5+acres.
ADDRESS:
rtman
CITY. STATE, ZIP.
On, 22920
TAX MAP PARCEL(IF KNOWN):
70-3 1
ZONING (IF KNOWN):
RA
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE)
F
ACREAGE OF PARCEL'
1
NO.OF GUEST BEDROOMS:
1
USING ACCESSORY STRUCTURES?
❑ YES ®NO
WHOLE HOUSE RENTAL?
I ❑ YES ® NO
2 Property Owner/Operator Information
NAME:
ana
ore
HOMEADDRESS:
15
rtman
CITY, STATE. ZIP:
Afton,
22920
PHONE NUMBER:
S 1- 0
- 03
EMAIL:
n-a@yahoo.com
3. Responsible Agent Information by the Albemarle County
The responsibleggentmustbeavailable within 30 miles ojthe homes[ayat ail times during a Community Development Department
hftruse, and mu��resp andattempt ingoodfaith to
resolve anycomplaints within 60 minutesof being contacted. UBIE /h- 7n��_
NAME: Juana Moore
HOME ADDRESS-
Cl rY. STATE, ZIP.
PHONE NUMBER: Io01-oVV-oVU.1 I EMAIL: Imoore—Oana@yahoo.com
4.5ignature
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 I understand them, and that I will abide by them.
SIGNATURE:
t V Fee Anal: $158
c
Receipt #:�
ID Ck#:
Receved by: S
HS#
DATE:
CO. OFFICE USE ONLY
v inspection date. !
ass ❑Fail 2nd inspection date:
Food Service (it necessary):_
Notes:
❑Pass []Fall
oid
ln �rkin ❑ ID
RevieLIDate: v
[ Approved I] Denied