HomeMy WebLinkAboutHS202200048 Approval - County 2022-11-18APPROVED
Commby the Albemarle County
Date b qY iq Development , Department
File I --
Homestay
Zoning Clearance Application
;v Albemarle County
Community Development
401 McIntire Rd., North Wing
Charlottesville, VA 22902
r rxra`t" Phone 434.296.58321 Fax 434.972.4126
Submit this completed application with the foliowin Iess Applicationfee:$173.76
1. Floor plan/property sketch with labeled structures used for the homres ay, guest bedrooms, towner's bedroom, outdoor lighting sso
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)
I. Homestay Information
Resider,hallyzoned andrural area parcels of less than 5 acres mayhove 2guest bedrooms by-nght. Useafaccessory structures (if built before August 7, 2019) is
only Permitted by -right on rural area parcels of 5+ ocres. Whole house rental is onl
yPemlitted on rural area parcels of 5+acres.
ADDRESS: I'3'LG 5
CITY. STATE. ZIP:
TAX MAP PARCEL (IF KNOWN):
NA
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
NO. OF GUEST BEDROOMS: I USINGACCESSORY STRUCTURES? ❑ YES
2. Property Owner/Operator Information
''. NAME:
HOME ADDRESS:
CITY. STATE, ZIP:
S
ZONING (IF KNOWN):
ACREAGE OF PARCEL:
NO WHOLE HOUSE RENTAL? ❑ YES
NO
PHONE NUMBER ,,c 1
3 �r7 - 05 — J EMAIL:
°� _ -----
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay at all times duringo homestay use, and must respond and attempt in faith to
resolve anycomplaints within 60 minutes of being wntacted.
NAME:
HOME ADDRESS:
CITY. STATE, ZIP:
PHONE NUMBER:
4.Signature --- - -
I hereby apply for approval to conduct the homesay identified above, and certify that this address is my legal residence, and that I own
the property or that 1 have recieved a special exception to operate the homesay as a resident manager. 1 also certify that I have read the
restrictions on homesays, that I under n them, nd that I will abide by them.
SIGNATURE: .- �. —
DATE: i /0
FOR OFFICE USE ON Y
Fee Amr $169 + 4% Date Paid:
i SSafetyinspection date: V ass ❑ fail 2nd inspection date:
Receipt r: VDH F ❑Pau ❑pail
Food Service (If
Ckx: necessaryY. - ❑ Hoarnhan
❑ Parking lN/'� //
Notes: _F.lN 1 J aI'Li /t
Received Reviewd By:
Date: 10�)q 22