HomeMy WebLinkAboutHS202100033 Application 2023-01-17Homestay
Zoning Clearance Application
�., Albemarle County
r~ 9m Community Development
= 401 McIntire Rd., North Wing
Charlottesville, VA 22902
si>rKr.,r Phone 434.296.5832 1 Fax 434.972.4126
Application fee: $IM76
Submit this completed application with the following or in or to the address above: A,,lkad +$119+T«nmkeySu ,aWs4.76+1.,�jon$50
1. Floor plan/propertysketch 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 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
Residentiallyzonedandrurol area parcels of less than 5 acres mayhave 2guest bedrooms by -right Use of ancessorystructures (if built beforeAugust 7, 2019) is
onlypermitted by-righton rural arm parcels of 5+acres. Whole house rental isonlypermittedon rural area parcels of 5+ocres.
ADDRESS:
CITY, STATE, ZIP:
G[srt
TAX MAP PARCEL (IF KNOWN:
Qy y` O pG b o L7 \ l 0
ZONING (IF KNOWN):
yNJt
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE):
(yye s} rot*c� e CA+t bv�it.( �)�
ACREAGE OF PARCEL:
1• �Z'i
NO. OF GUEST BEDROOMS:
`
USING ACCESSORY STRUCTURES?
❑ YES ❑ NO
WHOLE HOUSE RENTAL?
1 ❑ YES J,NO
2. Property Owner/Operator Information
NAME:
l-�C'3
HOME ADDRESS:
CITY, STATE. ZIP:
t:GJI Sv♦il.>Z v4. a-34�
PHONE NUMBER:
113 _ `
-yahoo.
L. v3v-881-33410
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestay stall times duringa homestay use, and mustrespond andattempt ingoodfaith to
resolveany complaints within 60 minutes of being contacted.
NAME
D¢S S.
✓Sj Qus J. N-
HOME ADDRESS:
Ia SS Fv�.
r C1v G,
CITY, STATE. ZIP:.
qJ 14.
VC.. .22'13
PHONE NUMBER:
�3� -a�S �i�
EMAIL:
y- ✓1I(�S deb �� G ov r (cM
L HSY-6Z5-t - S3YIo
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 orthat 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�l�ili 'ill abide by them.
SIGNATURE: I � j i . � Z�—) .-1�1 XU A W-0c, I DATE: I ( ' LI ! �3
Fee Arat: $169 +4% Date Paid:
Receipt #:
Ck#:
Received by:
HS#
FOR OFFICE USE ONLY
Safety inspection date: ❑ Pass ❑ Fail 2nd inspection date:
VDH Food Service lif
❑ Floorplan ❑ Packing
Reviewd By:
Date:
❑ Pass ❑Fail
❑ ID
Approved 0 Denied
:w`tgy Albemarle County
ort-T
y ` - f nlly DeveloPmevt
Sh
erm Rental Registry �mm�
u � j_ r 401 McIntire Rd. North Wing
Cluarlottesville VA 22902
m Annual Application i s Phone434.2965832
r�am�tr wwwalbemarleorg
Prior to opening for business, all operators of short-term rentals (including homestays and previously approved bed and breakfasts and
accessory tourist lodging rentals) must
• Register with this form
• Obtain an approved moinP- clearance (requires VDH and building/fire safety inspection)
• Register fora business license and remit required taxes
Annually following the initial approvals, all operators of short -tern rentals must
• Renew their registration with this form
• Pass a fire safety inspection
• Renew their business license and remit required taxes
Fields marked with an'ater6k are the minimum required for registratwn.
L Short Term Rental Information
A mhokhouserental is a short term rental of homedurifgwhich the owner is not required to be present Wholehouse rentalsare only Permitted on
Rural Area parcels of 5+aanm
•APPROVEDHOMESTAY(I-M BED AND BREAKFASr(BNB), ORACCESSORY
TOURIST LODGING (ATL)CLEEARANCE-P-rE-RMIT NUMBER 0FAPPU/CABLE)1:
--- -- -
'ADDRESS:
-
'CITY,STATE,ZIP,
E, ` Me \!d •1 n t c>_- ZZ 3lG
TAX MAP PARCEL(IF KNOWN):
\ t bO
ZONING(IFKNOWN}.
GUESfBEDROOMS-,
1
WHOLE NOUSERENTAL
pyES
2 Property Owner/Operator Information
•NAME:
i eb . F1-\`\ 5 . ao,& 1 .q.la;� N. i f, no1cS
'HOMEADDRE55
12,26 � Ci -G
cm,srATE,nP
"6,n\\.e- YN« \ f\-\(i_. ZZ93 W
PHONE:
43tl-
n a'i:S
EMAIL-
f4 r\\c1.S�L Cc.YN
u
3. Responsible Agent Information
The responsiblearntmust be available within miles of the homestay at all times during a homestay use, and must respond and attempt ingood faith to
resolveanycomP rots within 60minutesof beingwntacted.
B/OPERATORISRESPONSIBLEAGENT;
ONO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME
j
ADDRESS\TATE,ZIP
\ rr\(G \i114 2Z.43,,i-
PHONE,
a..�31(1, 2� (OZX—j
, J n
EMAIL
POROFFICEISEONLY - _ Date Paik_J_
FeeAmt D$27 D$owithdeararreappBcation Ck#.
Receipt6: Recelvedbr.
❑Accepted El Denied
Reviewed br.
R,qlbtrationDYcJ_J
www,alhemarleorg/Inmestays v, 9.17,2DI Paae1 of 1
r-
a s,
S' f,
- -T
5 �ooc-
RESPONSIBLE AGENT TEMPLATE WORDING
EDIT AS DESIRED
INFORMATION HIGHLIGHTED MUST BE INCLUDED IN NOTICE
Jan. 3, 2023
Deborah Reynolds
1285 Templeton Circle
Earlysville, Va. 22936
Phone: 434-882-3346
rynldsdeb@yahoo.com
Dear Albemarle County Community Development,
I'm writing to provide notice to all of my adjacent property owners that I have applied to conduct a
homestay use on my property at 1285 Templeton Circle. The purpose of this notice is to identify the
emergency contact/responsible agent for the homestay.
I want to maintain good neighborly relations, so I will strive to maintain a quiet homestay that does not
impact my neighbors. However, if any issues should arise during a guest's stay, please contact me and I
will respond to any issues and attempt to resolve them within 60 minutes of being contacted.
[Responsible Agent name]: Deborah Reynolds
[Responsible Agent telephone number]: 434-882-3346
Sincerely, F
De rbo ah d David Reynolds