HomeMy WebLinkAboutHS202200068 Approval - County 2022-12-16APPROVED
by the Albemarle Count`" ""� Albemarle County
Homesta y S� Community Development
Y Comm n'ty De elopment Departmen ' I 401 McIntire Rd., North Wing
ry9��+
'` ':� =>'� Charlottesville, VA 22902
Zoning Clearan4# r1---- 1wil Phone 434.296,58321 Fax434.972.4126
Application fee: $173.76
Submit this completed application with the following online or to the address above: A,pritation$119+Te<hn,l,,S111,19e$4.76+lr,e Ip,$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)
1. Homestay Information
Residendallyzonedand ruml area parcels ofless than 5 acres may have 2guest bedrooms by -right Use of accessory structures (if built before August 7, 2019) is
only permitted by -right on tural area parcels of 5+aaes. Whole house rental isonlypermitted on rural area parcels of5+acres.
ADDRESS:
I I Q� A'1Kf D RE ST O PIC L e
CITY, STATE, ZIP:
AR)-OTTESVILt.�-, VA a2 cl
TAX MAP PARCEL (IF KNOWN):
' lUI Dt�O — D/700
ZONING (IF KNOWN4o.2
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
s� A
SyL VIC J -RC E
ACREAGE OF PARCENO.OF
GUEST BEDROOMS:
'
USING ACCESSORY STRUCTURES?
❑YES VNO
WHOLE HOUSE RENTAL?
❑
2. Property Owner/Operator Information
NAME:
S LVIA
CECHoVA
HOME ADDRESS:
I^ Q R �— c 'T' I P,. � F,
CITY. STATE , ZIP:
r/'
,At n �A
Cyr T R � ( E S ti l L L. (—✓ VA._ � ,U)701
PHONE NUMBER: -
_ C�-LI` _ 6 2
EMAIL:
' / I'
S' L V i G1c mo
3. Responsible Agent Information
OM
The responsible agent must be available within 30 miles of the homestayatall times during a homestay use, and must respond and attempt ingood faith.to
resatw anycomplaints within 60 minutes of beinscontacted.
NAME:
T4IE, TSr` 'C t1J h 1JVV ,
HOME ADDRESS:
CITY, STATE, ZIP:
PHONE NUMBER:
EMAIL:
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 t 4% Date Paid: I I 22
Receipt It:
Received by:
Hs#MZ2 -lab
DATE:
FOR OFFICE USE ONLY
Safety inspection date: s 0 Fail 2nd inspection date: ❑ Pass 0 Fad
VDH Food Service (d
Notes:
13Floorplan P rl'n ID
Reviewd
Date: f —
Approved Denaed
0 A,