HomeMy WebLinkAboutHS202200047 Approval - County 2022-12-05APPROVED
by the Albemarle County
Homesta :,ommunity�p y�IP t Department n ,,,�t CommuAlbemnity
Development
County
II I J) Community Development
Y Gate A , 1 401 McIntire Rd., North Wing
t tfi Charlottesville, VA 22902
Zoning Clearance i� `> _' Phone 434.296.58321 Fax 434.972.4126
Application fee: $173.76
Submit this completed application with the following online or to the address above: APPIIca1ion$119,$4.76-Irs tion$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. Copiesof twoformsof verificationof 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 2guest bedrooms by -right. Use of accessorystructures (if built before August 7, 2019) is
onlypermitted by -right on rural area parcels of 5+ocres. Whole house rental is only permitted on rural area parcels of 5+acres
ADDRESS:
3161 Shannon Drive
CITY. STATE, ZIP:
I Keswick, VA, 22947
TAX MAP PARCEL (IF KNOWN):
I 79C--OA-5
I
ZONING (IF KNOWN):
Rural
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
ACREAGE OF PARCEL:
3.6
NO.OFGUEST BEDROOMS:
2
USING ACCESSORY STRUCTURES?
❑VES NO
WHOLE HOUSE RENTAL?
❑YES ®NO
2. Property Owner/Operator Information
NAME:
Daniel J Hager II
FIOMEADDRESS:
3161 Shannon Drive
CITY. STATE. ZIP:
Keswick VA 22947
PHONE NUMBER:
434-466-6855
EMAIL:
djhager2@aol.com
3. Responsible Agent Information
The responsible agent must beavailable within 30 miles of the homestay atoll times during o homestay use, and must respond and attempt in good faith to
resolve any complaints within 60 minutes of being contacted.
NAME:
Daniel J Hager II
HOME ADDRESS:
3161 Shannon Drive
CITY. STATE, ZIP:
Keswick, VA 22947
PHONE NUMBER:
434-466-6855
EMAIL:
djhager2@aol.com
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
Fee Amt$169+4% Date Paid:
Receipt #:
Ck#:
Received by:
HS#
Daniel J Hager II
FOR OFFICE
�USE
�ONLY
T 7 Safety inspection date: Y ss Fail
VDH Food Service (if necessary):
Notes
DATE: 1 10/05/2022
2nd hrspection date: []Pass []Fail
QP66"plan. rking I] ID
Reviewd By:
Date:
[.Approved ❑ Denied