HomeMy WebLinkAboutHS202000028 Approval - County 2023-02-01HOLY estay
Zoning Clearance Application
- Albemarle County
Community Development
* 401 McIntire Rd., North Wing
���•\�', Charlottesville, VA 22902
Phone 434.296.5832 1 Fax 434.972.4126
Application fee: $173.76
Submit this completed application with the following vnliD,_ortothe address above: Appnweon$119,TeIWcaysvrrnprae$4.76Hmpecpca$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
Residentially zoned and rural area parcels of less 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 rural area parcels of 5+acres. Whole house rental is only permitted on rural area parcels of 5+ acres.
ARESS'DD
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CTfY. STATE_ 71P:
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TAX MAP PARCEL (IF KNOWN):
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ZONING (IF KNOWN:
ADVERTISED NA ME OF HOMESTAY III` APPLICABLE):
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OO Imd
el,
ems/ e ACREAGE OF PARCEL:
NO. OF GUEST BEDROOMS:
— USING ACCESSORY STRUCTURES?
❑ YES
❑ NO WHOLE HOUSE RENTAL? ❑YES I�'rf(17
2. Property Owner/Operator Information
NAME: ClS rf7. f%
l� r
HOME ADDRESS: �/ v, �✓ oll %
CIY. STATE. ZIP: �2 2 S3 Z.
PHONF NUMBER: Elftaff me's 240) a dH
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.
NAME:
I
e7` 1
HOME ADDRESS:
e
CITY, STATE, ZIP.
I
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.) also certify that I have read the
restrictions on homestays, that I underMnd them7ard that I wilt ah-,ao ha thorn
I. SIGNAL URE: i /C 'dam_.?�iwM! ���ti--�.7 -/,— I DATE:
FOR OFFICE USE ONLY
Fee Ant: $759 • C% Date Paid Safely inspection date l�1' ass ❑ Fail Zed in,faecuo,, dare ass ❑ Fail
Receipt N: VDH Food Service (if necessary): ❑Floorpian ❑Eaqking ❑ ID
Ck-Y: _ Notes: Ravlelvd By'
Received by: Date:
HSJ
pproved F1 Denied