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HomeMy WebLinkAboutHS202200050 Application 2022-10-10Homestay Zoning Clearance Application Submit this completed application with the following online or to the address above: Albemarle County Community Development ]- 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) 1. Homestay Information Residentially zoned and rural area parcels of less than 5 aaes may have 2guest bedrooms by -right. Use of accessory structures (if built beforeAugust 7, 2019) is onlypamitted by -right on rural area parcels of 5+acres. Whole house rental is onlypermitted on rural area parcels of 5+0cres. ADDRESS: 2507 Cedar Ridge Ln CITY, STATE, ZIP: harlottesville, VA, 22901 TAX MAP PARCEL (IF KNOWN): ZONING(IF KNOWN): RA ADVERTISED NAME OF HOMESTAY (IF APPLICABLE): ACREAGE OF PARCEL: 2.01 NO. OF GUEST BEDROOMS: 1 USING ACCESSORY STRUCTURES? FED YES ❑ NO WHOLE HOUSE RENTAL? 1 ❑ YES ONO 2. Property Owner/Operator Information NAME: NicolaasJackie van der Westhuizen HOME ADDRESS: 2505 Cedar Ridge Ln CITY, STATE, ZIP: Charlottesville, VA, 22901 - PHONE NUMBER: 4349870112 EMAa: Jackie.van.der.westhuizen07@grri 3. Responsible Agent Information The responsible agent must be available within 30 miles of the homestay at all times during a homestay use, and must respond and attempt in good faith to resolve any complaints within 60 minutes of being contacted. NAME Jackie van der Westhuizen HOME ADDRESS: 2505 Cedar Ridge Ln CITY, STATE, ZIP: Charlottesville, VA, 22901 PHONE NUMBER: 4349870112 EMAIL: ackie.van.der.westhuizen07@gmaA 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 I understand them, and that I will abide by them. SIGNATURE: Nicolaas Jackie van der Westhuizen ogba'ry•'emdbyHsaaaaw.ckbvan dr1Wrsba—n DATE: /25/2021 Dale :2021G.251113:23- Fee Amt. $158 Date Paid: Receipt #: Received /^by: HS# FOR OFFICE USE ONLY Safety inspection date: ❑ Pass ❑ Fail Zinc inspection date: VDH Food Service (if Notes: 13 Floorplan Parking Reviewd By: Date: O Pass ❑ Fail ❑ ID ❑ Approved n Denied N 0 L u T �Wlw 2 (n 0 0 c 3 @ C � f0 @ i N 0 � O O) T @ @ fl. T X � C N C N N N � L • N C O