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HomeMy WebLinkAboutHS202200063 Approval - County 2023-01-11© Homesta APPROVED f*+a,. Albemarle county Y by the Albemarle County #` : , z community Development 401 McIntire Rd., North Wing Development Departme �=< Charlottesville,VA22902 Zoning Clearance �`ica�io °j�x:lt'' Phone 434,296.58321 Fax 434.972.4126 File — Submit this completed application with the followin AppliCation fee: $173.76 84Dlineortotheaddressabove: APPllmuen$119.um�m Vn ,ch.ps4.76.ImpM $so 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 spottguest bedroom). 2. Copies of two forms of verification of residency (one govemment 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 Residentiallyzoned and ruralarea parcels of less than 5 acres may have 2guest bedroomsby-right Use ofamessmystru rim(if built beforeAagust 7, 2019) is onlypermitted by -right oo rsnal area parcels of5+aces. Whole house rental is onlypennittedon nrral area pdrcdsof 5+acres ADDRESS: 1 6 M l tl l "V, ` CITY. STATE. ZIP: OA A�O ffJ2�I V A Zell TAX MAP PARCEL (IF KNOWN);ZONING (IF KNOWN): ADVERTISED NAME OF HOMESTAY(IFAPPLICABLE): ✓1/A ACREAGE OF PARCEL: 2 Q NO. OF GUEST BEDROOMS: Z 1 USING ACCESSORY STRUCTURES? ❑ YES NO WHOLE HOUSE RENTAL? ❑ YES NO 2. Property Owner/Operator Information NAME: Maid Dal aVf') HOME ADDRESS: GTY, STATE, ZIP: ✓I *s !1 Lt V,4 2 Z q 11 PHONE NUMBER: 5µ0— S eft — 8 a7 Z EMAIL: 3. Responsible Agent Information Then'sponslbkagent must be available within 30 miles of the homestay atoll times during a homestay use, and must respond and attempt in good faith to resoheanvocmptaints within 60 minutes of being contacted. NAME: HOME ADDRESS: CITY, STATE, ZIP: PHONE NUMBER: V'Z I Z I EMAIL: C4a( 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: I U AhL) (' )a �TE: t O Z U L I! __ l ? i17/Z- FOR OFFICE USE ONLY Fee Amt $169+4% Date Paid:I I it 1,2,2 Safety inspection date: 17 2' �ZG{yPass ❑fail 2nd in 'on date-T ❑ Pass Fail Receipt lt06bys VDH Food Service iif necessary): loaplanadlloalfI'�'an 10 h ,5 Notes: Reviewd.6y: Received by: tLM Date:k i 1- HSxX`'!''A-=103 I Approved Denied 0 sIn