HomeMy WebLinkAboutHS202200068 Application 2022-11-09Homestay
Zoning Clearance Application
f+^ru Albemarle County
`y Community Development
=r in 401 McIntire Rd., North Wing
Charlottesville, VA 22902
x�"rerass* Phone 434.296.5832 1 Fax 434.972.4126
Application fee: $173.76
Submit this completed application with the following online ortothe address above: Appli eiw$119+T«hwloeysurcharge$4.76+lnspedon$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
Residentiollyzoned 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
only permitted by -right on rural area parcels of 5+acres. Whole house rental is only permitted on rural area parcels of 5+acres.
ADDRESS:
'V AK D REST CAPC LE
CITY. STATE, ZIP:
�T�
AR wT TESV I L LfE-VA .2950/
TAX MAP PARCEL (IF KNOWN):
061 V)I — OZ — - mo
ZONING(IFKNOWN):
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
S (L U I C
y1I
I tr',4l.. /� E
ACREAGE OF PARCEL:
NO. OF GUEST BEDROOMS:
I
USING ACCESSORY STRUCTURES? ❑YES *E(NO
WHOLE HOUSE RENTAL?
OYES XNO
2. Property Owner/Operator Information
NAME:
.S LVIA CEC 1OVA
HOMEADDRESS:
/1
A K -f0 R1� S ( ci Pe L&
CITY, STATE, ZIP:
Cr
Cm 4 K� I ' E S V I L L- E V 4 oC a/ 0
PHONE NUMBER:
_ LI-gj — 6 0 8A
I EMAIL:
S `Uickq ' rn�
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:
TTlG ?STHF, AS
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 I have read the
restrictions on homestays, that 1 understand them, and that I will abide by them. ,
SIGNATURE: `'T?.Vkt/L/ ( . 1-7wlf X-Vt-/ I DATE: I M Jr x -1) ( -l;O U
Fee Amt$169+4% Date Paid A22
Receipt#:
Ck#:
Received by.
Hs#2D?? —tog
FOR OFFICE USE ONLY
Safety inspection date: ❑ Pass ❑ Fail 2nd inspection date:
VDH Food Service (if necessary): ❑ Floorplan
Notes:
Reviewd By:
Date-
[-] Approved
❑Pass ❑Fail
❑ Parking ❑ ID
❑ Denied
Short -Term Rental Registry
Annual Application
sT oea
�2
Albemarle County
Community Development
$ m
401 McIntire Rd. North Wing
Charlottesville, VA 22902
�rRmN�P
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 zoning clearance (requires VDH and building/fire safety inspection)
• Register for a 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 firesafety inspection
• Renew their business license and remit reauired 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 (ATL) CLEARANCE PERMIT N UMBER (IF APPLICABLE):
'ADDRESS:
/ ,0 01-K
rD �,Es / ! /' R Al /_
aTv,srATE,nP:
�iy(Ap(�T�CSV(LLC= ✓q �29D/
TPXMAP PARCEL OF KNOWN):
06/ Vl%—CV4 —017 O
ZONING (IF KNOWN):
�t}-
GUESTBEDROOMS:
OAlL
WHOLE HOUSE RENTAL
y�r''
❑YES 160
2. Property Owner/Operator Information
'NAME:
S/ LV 14 dL- tr ' r
'HOMEADDRESS:
pCFf0
Net W rOR E s P,C tE
'CITY, STATE, ZIP:
M4 F-W I tGSI/(u.s H oialol
PHONE:
tf;4 ;24q-60jP2
EMAIL:
)/f J'
LVckcL
�� �)Q /�nnf-
V"VKil.i • tNr',
IIiM
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 QO minutes of being contacted.
OWNER/OPERATOR IS RESPONSIBLE AGENT:
I RYES ❑NO IF NO,COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOME ADDRESS:
CITY, STATE, ZI P:
PHONE:
EMAIL
FOR OFFICE USE ONLY
Date Paid: --/--/_
Fee Amt: 13$27 0$0 with clearance application Ck#:
Receipt#:
Received
❑ Accepted ❑ Denied
Reviewed by:
Registration Date: _/ J_
www.albemarle.org/homestays v. 9.17.201 Page 1 of 1
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