HomeMy WebLinkAboutHS202000025 Action Letter 2022-11-10APPROVED
by the Albemarle County
Community Development Departme 'AI4 Albemarle county
Homestay Date_ Community Development
)x 401 McIntire Rd., North Wing
Ile __ '- :R'� Charlottesville, VA 22902
Zoning Clearance ppitcatior____ sa t`' Phone 434.296.58321 Fax 434.972.4126
Application fee: $273.76
Submit this completed application with the following APOIIntlonsua.Tech.blorrs„rm.re+za.2a.tManlo„aso
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 verfication of residency (one government Issued with photo ID + one listingthe 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 2ueest bedrooms by -right Use ofaccessorystructures fif 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:
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CITY, STATE, ZIP;
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TAX MAP PARCEL (IF KNOWN):
I^��,L50'�
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ZONING (IF KNOWN):
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE):
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ACREAGE OF PARCEL:
NO. gF.GUEST BEDROgMS
3
USING ACCESSORY STRUCTURES?
❑YES NO
WHOLE HOUSE RENTAL?
I B`YES 0NO
2. Property Owner/Operator Information
NAME:.
:SAW\C-S
HOME ADDRESS:
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CITY, STATE, ZIP
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PHONE NUMBER
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EMAIL:
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3. Responsible Agent Information
The responsible agentmust be available within 30 miles of the homestay at all times duringo homestay use, and must respond and attempt in good faith to
resolve any complaints within 60 minutes ofbeingcontocted. 4 If , t.,-^
-NAME:
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HOMEADDRESS:
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CITY, STATE, ZIP:
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-PHONE NUMBER:
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EMAIL:
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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: / (nr� DATE:
- - l0 1� LL
FOR OFFICE USE ONLY
Fee Amt $169 +4% Date Paid _ Safety inspection date: - �' -1Z04 ❑ Fail 2nd inspechon date _ ❑ Pass Fail
Recept #: __. _ VDH Food Service (if necessary):Plan _ _ ',king
Ck#: Notes:
_ Reviewd By: f=�lP•--4/L_
Received by. Date.
HSu l Approved
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