HomeMy WebLinkAboutHS202200055 Application 2022-10-21to
Homestay
Zoning Clearance Application
rc + Albemarle County
g 'y Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
�r>rmvlr Phone 434.296.58321 Fax434.972.4126
Application fee: $173.76
Submit this completed application with the following online or to the address above: Appgcation$119+TechnologySurcharge $4.76+Inspection $50
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 acres may have 2uuest bedrooms by -right. Use of accessory structures (if built before August 7, 2019) is
onl ypermitted by -right on rural area parcels of 5+ acres. Whole house rental is only permitted on rural area parcels of 5+acres.
ADDRESS:
CITY, STATE. ZIP:
TAX MAP PARCEL (IF KNOWN):
6 HOC--00 -" — 6
ZONINGWN):
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
=RCEL:
NO. OF GUEST BEDROOMS:
USING ACCESSORY STRUCTURES?
�ES
❑YES NO
2. Property Owner/Operator Information
NAME:
HOME ADDRESS:
ee,f yl vC.
CITY, STATE, ZIP:
V-16 t
-1
I I,, I V- 4 1 n OL
PHONENUMBER:
'3 , o(o ,
EMAIL:
tn/Qrt55ChwQb�J at nr-
alm
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestayat 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:
HOME ADDRESS:
CITY, STATE, ZIP:
PHONE NUMBER:
EMAIL:
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 1 have read the
restrictions on homestays, that I understand them, and that I will abide by them.
SIGNATURE: kw&T 7)q A- roc af� I DATE: I 70 1/i 1, 7
Fee Amt: $169 + 4%// ,�, Date Paid � l0 «
Receipt #: W L4
Ck#: -I I q tt;L
Received by: 4p^�
HS#LXSef3a —�Jy5
FOR OFFICE USE ONLY
Safety inspection date: __. ❑ Pass ❑ Fail 2nd inspection date:
VDH Food Service (if necessary):
Notes:
❑Floorplan ❑Parking
Reviewd By:
Date:
[]Pass []Fail
❑ ID
❑ Approved ❑ Denied
Short -Term Rental Registry
Annual Application
�y or ate„
Albemarle County
Community Development
g
401 McIntire Rd. North Wing
Charlottesville, VA 22902
VrRGIMP
Phone 434.296.5832
www.albemarle.org
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 zonineclearance(requires VDHand building/fire safety inspection)
• Register fora business license and remit required taxes
Annually following the initial approvals, all operators of short-term rentals must:
• Renew their enrollment on the registry with this form
• Pass a fire safety inspection
• Renew their business license and remit required taxes
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 Whole house rentals are only permitted on Rural
Area parcels of 5+ acres.
'APPROVED HOMESTAY (HS), BED AND BREAKFAST (BNB), OR ACCESSORY
TOURIST LODGING (ATU CLEARANCE PERMIT NUMBER (IFAPPLICABLE):
'ADDRESS:
z We, f • �� I �' aL
'Cr Y,STATE,ZIP.
TAX MAP PARCEL (IF KNOWN):
o6 Z06 —0d —00 0-3300
ZONING (IF KNOWN):
GUESTBEDROOMS:
Z
WHOLE HOUSE RENTAL'
OYES .)dNO 'tcc c/ GQr
11, .. r 0 0
2. Property Owner/Operator Information
"NAME:
QA-3 M . SCVtwQ v
'HOMEADDRESS:
�'- Kt �,Q 1p� YfNeL
'CITY,STATE,ZIP
/i
CI te—vt# P5j j VI I r) 1R 1.2r
PHONE:
O 75-
EMAIL:
1.t10.4-5SGy4„ AAa(I
r(Ipt..,
3. Responsible Agent Information
The responsible agent must be available within �p 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.
OWNER/OPERATOR IS RESPONSIBLE AGENT:
13 YES ONO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOMEADDRESS:
CITY, STATE, ZIP
PHONE:
EMAIL
Fee Amt: 0$27 0$0 with clearance application
Receipt #:
Date Paid:
Received
❑ Accepted ❑ Denied
Registration Date:_/_/_
www.albemarle.org@wmestays v. 9.17.201 Page 1of 1
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