Loading...
HomeMy WebLinkAboutHS202300006 Application 2023-01-17Homestay Zoning Clearance Application mio\ 10: SOW Albemarle County Community Development 401 McIntire Rd., North Wing is Charlottesville, VA22902 Phone 434.296.5832 1 Fax 434.972.4126 Application fee: $173.76 Submit this completed application with the following online ortothe address above: Application $119+ Technology Surcharge $4,76+Inspection $50 1. Floor plan/property sketch with labeled structures used for the homestay, guest bedrooms, owner's bedroom, outdoor lighting and signage forthe 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 bythe Zoning Administrator) 1. Homestay Information Residentially zoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by -right- Use of accessory structures (if built before August 7, 2019) is only permitted by -right on rural area parcels of 5+acres. Whole house rental is only permitted on rural area parcels of 5+acres. ADDRESS: OO LA) 4 2O CITY, STATE, ZIP: 136 r O(,�Si3tdk A / 2 23 TAX MAP PARCEL (IF KNOWN): ZONING (IF KNOWN): ADVERTISED NAME OF HOMESTAY(IF APPLICABLE): �r(� ACREAGE OF PARCEL Zc_ NO. OF GUEST BEDROOMS: USING ACCESSORY STRUCTURES? I ❑ YES Y NO 7WHOLE HOUSE RENTAL? I ❑ YES KNO 2. Property Owner/Operator Information NAME: tj( IL 14, li?i iDyd 1t 4 /� HOME ADDRESS: � �4 CITY. STATE, ZIP: .� 7 1 (l/� Zz G� PHONE NUMBER: 3_ 2G' / EMAIL: u / 3. Responsible Agent Information The responsible agent must be available within 30 miles of the homestay at all times during a homestay use, and must respond and attempt in good faith to resolve any complaints within 60 minutes of being contacted. Wry`. NAME: Ant—L 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 1 have read the restrictions on homestays, that I u tand t and that wi a de by them. SIGNATURE: ht ZL,DATE: /Z ZoZZ FOR OFFICE USE ONLY Fee Annt: $169 + 4% Date Paid: Safety inspection date: ❑ Pass []Fail 2nd inspection date: []Pass ❑ Fail t�.l� Receipt 4: VDH Food Service (if necessary): ❑ Floorplan ❑ Parking ❑ ID ` ` S Ck# Notes: Reviewd By: `Q Received by: Date: v, HSa ❑ Approved ❑ Denied