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Home My WebLink AboutHS202200069 Approval - Agencies 2022-11-10Homestay Zoning Clearance Application Submit this completed application with the follow'Ing Qj�� or to the addre 1 Floor plan/property sketch with labeled structures used for the home ss above �► ��, Albemarle County I %r'' '%, Community Development 401 McIntire Rd , North wing • -_00 Charlottesville, VA 22902 Phone 434 296.5832 1 Fax 434 972 4126 Application fee: $173.76 Application $119 + Technology Surcharge S4.76 + In-Spection $50 stay, guest bedrooms, owner's bedroorn, outdoor lighting -ind 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 2 guest bedrooms by -right. Use of accessory structures (if built before August 7 2019) is only permitted by -right on rural area parcels o(5+acres. Whole house rental is only permitted on rural area parcels of 5+acres. ADDRESS: 2 `-I S� � ock off CITY, STATE, ZIP: (�p �� «&x^ TAX MAP PARCEL (IF KNOWN): � �� O � OO � � 38' � Q ZONING OF KNOWN): ADVERTISED NAME OF HOMESTAY OF APPLICABLE): %4' R 9 n/ � � ACREAGE OF PARCEL* ZODY] NO. OF GUEST BEDROOMS: 2--w, USING ACCESSORY STRUCTURES? 2. Property Owner/Operator Information ❑ YC; N NO WHOLE HOUSE RENTAL? ❑YES 361C NAME: 1`�C��A\�C� d� HOME ADDRESS: 1z0 Lam— 13 �CALK. L.&A C CITY, STATE, ZIP: Q C VVW4%*., Cj trI'� � � �'C 'Z Lel PHONE NUMBER: �� ZH� �ZtD EMAIL: ��'r��L G�h/� p�JO^�� 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: HOME ADDRESS: CITY, STATE, ZIP: PHONE NUMBER: 4. Signature odd (9gz & 0 7 000. U 4� �+ 2.010701-- Cl tot 7- EMAIL: 4ed7 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, tha I under tand then),and that i ide by them. IL SIGNATURE. V , - I F)ATF l 0 T (� i—b �f--Ll- %.,� 00000F JAZZ^ Fee Amt $169 +- 4% Rece pt # C:k#- Rece ived by H S ;. Dare Paid FOR OFFICE USE ONLY Safetv inspection date VDH Food I-)rr-vice (if necessary) PJotPs ❑ Ness ❑ F<Ill 2nd inspechon date• ❑ Floorplan Reviewd By Date Approved ❑ Parking ❑ Pass ❑ Fiil ❑ ID [:] Denied A (4/* ( 0000�h VwvQ Oemn% V;o AA CXON6, Low so Aammomw Payment Receipt Yomp- transaction has been successfully completed!! Your Confirmation number is 10004 9 98 Trans,Artlon ID: 2210261330870[)AO1t14'i2.il2lO/613_ili�b poi Ai"202 z 14: 32.22 JFSTJ Account Information Payment Type: Tex Payment B1*11 Payer Details !nins Dunlon 2.364 Mountain Brook Drive Chartottesvftle, VA 23226 Payment Details Payment Amount: $173.76 Total Amount: $173.76 Payment Method: Account Number: XXXXXXXXXXXXX4751 Routing Number: 06 1000052 Check Type: Checkmg Li Provide Sketch Here or Attach Sketch to This AppUcation ? f::: � OV Y**Mmk AV4c4Ntj COMMONWEALTH OF VIRGINIA VOTER CARD ID 388365994 DATE NO.ISSUED NATALIE GORDON DUNTON 2458 ROCK BRANCH LN NORTH GARDEN VA 22959-1724 LANGUAGE PREFERENCE English li i I II I� I I� I I II I I I I I I I II I II I I II I I I III VOTING LOCATION. RED HILL ELEMENTARY SCHOOL 3901 RED HILL SCHOOL RD NORTH GARDEN, VA 22959-1704 3/17/2020 F O DI H E R E LOCALITY PRECINCT ALBEMARLE COUNTY 302 - RED HILL DISTRICTS CONG 05 SEN 025 LOCAL. SAMUEL MILLER DISTRICT Voter Registration Office HSE 059 435 MERCHANT WALK SO STE 300 # PMB 160 CHARLOTTESVILLE, VA 22902-6514 434-972-4173 F O D H E R E FOR TOWN ELECTIONS: TOWN TOWN PRECINCT / DISTRICT TOWN ELECTION `✓OTING LOCATION Use back of form if your Address, Name and/or Language Preference has changed "' THIS CARn rANNnT RF HSFC PS InFNTI1 ICATION TO VOTF A PHOTO In IS REOIJIRF_n TO \/OTF IN PERSON. *** NATALIE GORDON DUNTON 2458 ROCK BRANCH LN NORTH GARDEN, VA 2.2959-1724 ELECT 13 REV 4/07 .•. Above is your new Voter Registration Card It provides the location where you vote and the districts assigned to your representatives in the U S House of Representatives (GONG), the Senate (SEN) of Virginia and House of Delegates (HSE) of Virginia your local governing body and, if elected your school board (LOCAL) Please check the personal information on this card If accurate detach and keep the card If any information is incorrect, now or in the future, please enter the corrections on the back of this card sign it. and return it to the Registrar in person or by mail A new card with your corrections will be mailed to YOU Short -Term Renta Annual Application Registry Albemarle County Community Development 401 McIntire Rd. North Wing Charlottesville, VA 22902 Phone 434.296.5832 wviw.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) nnust: • 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 regulred 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 I icense and rernit 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 TOURIST LODGING (ATL) (HS), BED AND BREAKFAST (BNB), OR ACCESSORY CLEARANCE PERMIT NUMBER (IF APPLICABLE): `ADDRESS: 2 � � S( v { r� 9 �� 13 �J L� 'GTY, STATE, ZI P: �� Ir V �L to � ,� gf TAX MAP PARCEL (IF KNOWN): D Q ^,OQ WPM- CY3�^�/� 0GUEST ZONING (IF KNOWN): BEDROOMS: WHOLE HOUSE RENTAL: ❑YES sr O 2. Property Owner/Operator Information *NAME: 'HOME ADDRESS: 2 t� s � p 15e-twt LkV 'CITY,STATE, ZIP: �O{ I� � PHONE: Z Z� ZqI Loi� � EMAIL: �h I�� G��trO�l�O/� e CfwiG. 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. OWNER/OPERATOR IS RESPONSIBLE AGENT: VeYES D NO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW NAME: HOME ADDRESS: CITY, STATE, ZIP: PHONE: EMAIL: FOR OFFICE USE ONLY Fee Amt: D $27 Receipt 4 D $0 with clearance application Date Paid Ck0 Received by ❑ Accepted Reviewed by% ❑ Denied Registration Date: / / www.aIbemarIe.org/homestays v. 9.17.20 1 Page 1 of 1