HomeMy WebLinkAboutHS202200041 Approval - County 2022-10-12Homestay
Zoning Clearance Application
Albemarle County
Community Development
T 401 McIntire Rd., North Wing
' Charlottesville, VA 22902
Phone 434,296.58321 Fax 434,972,4126
Application fee: $173.76
Submit this completed application with the following onlin or to the address above: APphcuh.S119.TRhrdMs,.rh,r,,sa7e-1,1 ii $0
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
ResidentiollVzoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by -right Use of accessorystructures (if built before August 7, 2019) is
onlypermitted by-righton runri parcels of5+acres. Whole house rentolis onlypermittedon rumlarea porceisof 5+acres.
ADDRESS: r 5o Sr-OaAAx y Eo a
CITY, STATE. ZIP: C11ar a I Q VI , A._ I A lol 9 O
TAX MAP PARCEL (IF KNOWN) �300—OO-O0-'I OOa-L QIO ZONING(IF KNOWN). Qy,.4J rJ-j
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE); SUVISt+ [-. d C S4%,tdto I
ACREAGE OF PARCEL: V. 3
NO. OF GUEST BEDROOMS I USING ACCESSORY STRUC❑ NO WHOLE HOUSE RFNTAL? ❑ YES Va] NO
2. Property Owner/Operator Information
NAME:
tY1Q AsWe
HOMEADDRESS:
/nLavo
�So 19 ro0. 4X e.
CITY. STATE. ZIP:
CLi Icrf-'ceS vl lIf- VA 03
PHONE NUMBER:
'3. Vrr - ou(4
EMAIL:
1'S'igtgy .9 ^''a�1.��
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay atoll times during a homestay use. and must respond and attempt ingood faith to
resolve any complaints within 60 minutes of being contacted.
NAME: fflgr'lJ'rll'Q L4V
HOME ADDRESS: 1-767 groki -t
CITY, STATE, ZIP: kgv-(o*eSV1
PHONE NUMBER: 3 g& 17- D tp Li 1 EMAIL:
Yr1 a la V � - ca�•-,J
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:
DATE: A/ r�L;-
FOR
OFtF CE ONLY GFeeAMLS169.4% DatePaid:_ Safety m5pernon dd"aO Fad 2nd Inspection date: 0 Pass ❑ Fal
Receipt k. VOH Food Service td necessary): xpUn mkmg -CID
CIA: Notes. Revicwd Bv. 449.1111�
Recnved by PROVED Da:e_
y th Albemarle County
H5° __ Wpproved Denied
eve% eneppf lartment
Date '162�
File