HomeMy WebLinkAboutHS202200008 Approval - County 2022-11-18APPROVED 4,j��
Albemarle County
by theAloemarleCou�tyCommunity Development
Homestay Ca nmby t), Albe re Co ,ol Mcmtire ltd., North wing
D P eparime Charlottesville, VA22902
Zoning ClearancgFAP ' ^^ /o-Zl_� Phone 434.296.58321 Fax 434.972.4126
Application fee: $173.76
Submit this completed application with the following.:•.;.- or to the address above: Appik.tansus+Techrrobgysmcmrge$4.76.Insp¢ction$50
1. Floor plan/property sketch with labeled structures used for the homestay, guest bedrooms, owner's bedroom, outdoor lighting
and signage for the homestay, labeled setbacks, and parking (minimum 2 + 1 spot/guest bedroom).
2. Copies of two forms of verification of residency (one government issued with photo ID + one listing the address - acceptable forms
include driver's license, voter registration card, U.S. passport, others as approved by the Zoning Administrator)
L Homestay Information
Residentially zoned and rural area parcels of less than 5 acres may have 2guest bedrooms by -right Use of accessorystructures (if built before August 7, 2019) is
only permitted by -right on rural area parcels of 5+acres. Whole house rental is a* permitted on rural area parcels of 5+acres.
ADDRESS:
�
CITY. STATE, ZIP:
GVA
7—Z-Q -
TAX MAP PARCEL (IF KNOWN):
ZONING (IF KNOWN):
A
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
I `V Cp
ACREAGE Of PARCEL:
3 s Z 7
NO. OF GUEST BEDROOMS:
USING ACCESSORY STRUCTURES?
I OYES 1$NO
WHOLE HOUSE RENTAL?
(DYES El NO
2 Property Owner/Operator Information
NAME:
/-- -
�t,Y` G u--
HOME ADDRESS:
H
CITY, STATE, ZIP:
{rv'�'rP5 �1\`e Va 2Z�t�3
PHONE NUMBER:
__
EMAIL: _r
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3. Responsible Agent Information
The responsiblealimt must be available within 30 miles of the homestay of oil times duringo homestay use, and must respond and attempt in good faith to
resolve any comploints within 60mmutes of beirlgcomacted.
NAME:
^ H
HOME ADDRESS:
r\
CITY. STATE. ZIP:
Z Z-:�A 0 3
PHONE NUMBER:
[MAIL
Wit
4.Signature
1 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 uiyl ryt_ao thA, and that 1 will abide by them.
Fee Amt S169+4 Date Paid:--M4—
ReceiptY#:: \'M���
Rcceived by: /J
HSM OC
FOR OFFICE
t USE �Y
Safety inspection date: V y, Pass ❑ Fail 2nd inspection date: __ ❑ Pass ❑ Fail
VON Food Service (if necessary):,
[]Floorplan �F�t/p)}arrk*k('nng� ❑ID
Reviewd By r-Itl�.�r
Date: V\ I V�
Ej/pprovLd Denied
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