HomeMy WebLinkAboutHS202200055 Approval - County 2023-01-19Homestay APPROVED
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Zoning Cle�a�n
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Submit this completed applicatimith the following onli w or to the address above:
Albemarle County
a ,2 Community Development
=f i< 401 McIntire Rd., North Wing
Charlottesville, VA 22902
'rnlpss* Phone 434.296.58321 Fax 434.972.4126
Application fee: $173.76
ApPlkati $119.Tedw*Iry Surcharge$4.76* nnptt $W
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
Residentiollyzoned andruralareaparcelsof less than 5alresmayhove 2uuestbedroomsby-fight. Useofaoc ssorystructures(%built before August 7,2019) is
antYpermittedby-right on rural arm parcels of 5+acres. Whole house rental is mlypermittedon rural areaparcels of 5+acres.
ADDRESS:
CITY, STATE. ZIP:
0 Y h 1 ZR I
TAX MAP PARCEL (IF KNOWN):
Q p -. 0 0 -- _
O 330 0
ZONING (IF KNOWN):
ADVERTISED NAME OF HOMESTAY(IF APPLICABLE):
ACREAGE OF PARCEL
NO. OF GUEST BEDROOMS:
USING ACCESSORY CTURES?
STRU
O'GES NO
WHOLE HOUSE RENTAL?
I] YES ONO
2. Property Owner/Operator Information
NAME:
` 4 ,µ
HOME ADDRESS:
4- ,eSr 1 yZ
CITY, STATE. ZIP:
d. 1-16 1 ✓ Z f
PHONE NUMBER:
3, q 06 , EMAIL:
INQq5-,znW4b -
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homestayatall timesduring a homestayuse, and must respond and attempt in good faith to
resolve any complaints within 60 minutes of being contacted.
NAME:
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 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: Ora?/t —27-1 ., � I DATE: I ,6//Z/77
FOR OFFICE USE ON Y
Fee Amt$166(n 9444%/_'1Da`te PaidA0j1g(aa I Safoyinspectiondate: Pazs OFall
Receipt M:' a5 '
Ckg: - t 09 t2
Receivedby: D1d�
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Notes
2nd inspection date: 0Pass ❑Fail
�o,plan Arkin ❑JO.
RevievM By: '!
0
Date: a
proved 0 Denied