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Home My WebLink AboutHS202300015 Application 2023-02-10^te€ Albemarle County Homestay Community Development 401 McIntire Rd., North Wing Charlottesville, VA 22902 Zoning Clearance Application>xa r Phone 434.296.5832 1 Fax 434.972.4126 Application fee: $173.76 Submit this completed application with the following online or to the address above: Application $119+TechnoloVSurcha,ge$4.76-ir,ecnon$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 I D+ 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. ADDRESS: S 1 L{, SI �l:Ql;(rit.; h�, ❑TY,STATE,ZIP: CiulZIr VA 2Zg3z TAX MAP PARCEL (IF KNOWN): D56A I —<A —00— IlA kS ZONING (IF KNOWN). ADVERTISED NAME OF HOMESTAY (IF APPLICABLE): ACREAGE OF PARCEL: NO. OF GUEST BEDROOMS: USING ACCESSORY STRUCTURES? IS YES ❑ NO WHOLE HOUSE RENTAL? ❑ YES ® NO 2. Property Owner/Operator Information NAME: I39hD L JLN N&CA,45 HOMEADDRESS: 5-130li 5T nAVkkc CITY. STATE, ZIP: CYLi?-LTi%fk2 PHONE NUMBER: cc21g32 $13 7E5 IMI EMAIL: 0,D1G4AN5&6"tL , con 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 ingood faith to resolve any complaints within 60 minutes of being contacted. NAME: 7V-1A0 'Dl(,&AA�+S HOME ADDRESS: S13q 17TApt: CITY. STATE, ZIP: CYLQZ.0 I (JA 2716? PHONE NUMBER: 6 l3 ZSS `1938 EMAIL'. ��iGGA JS C& („MA:L. CJr'h 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. 1 also certify that I have read the restrictions on homestays, that I understand them, and that I will abide by them. SIGNATURE: DATE: I Q7 �ZJ FOR OFFICE USE ONLY Fee Amt: $169 +4% Date Paid: Safety inspection date: []Pass ❑ Fail 2nd inspection date: ❑ Pass ❑ Fail Receipt #: VDH Food Service (if necessary): ❑ Floorpian ❑ Parking ❑ ID Ck#: Notes: Reviewd By: Received by: Date: H5# Approved Denied C )4, G'------------------------------ 6 00 o I 21'-1113/16" � � I I I 34' I I I I - �4MEn5 I I I [;LOEaJM J I QO i I I I ---- --- _ - I I I I I I --------- 10' 34' M SITE SKETCH - SCALE: 1/8 IN = 1 FT ( tFLEQWE "5Ttt" G4&, SHEET: SCALE: DATE: SITE SKETCH PFA BRAMANTE S: Noted 1E35 Rorer Pve #3 Wayrasbora, VA 2ri@J A4.1 11/17/20 P^0"e s+osazsazz PPPER SIZE- 18 HOMES � HCORPORPTED �.al GARAGE PLAN - 2ND FLOOR GARAGE PLAN - 1ST FLOOR GARAGE PERSPECTIVE VIEW SHEET: SCALE: DATE: GARAGE PLAN "MAP MANTE�❑1/a - 1/17/20 1st & 2nd Floor Plans/ Overview 105 R Av k2 Waynee , VA 22"0PAme 590.9M13.5432PAPERSI2E:19 NCORPORATED ..m ae�. n�l C GARAGE FRONT ELEVATION GARAGE LEFT ELEVATION GARAGE RIGHT ELEVATION GARAGE BACK ELEVATION SHEET: MSDATE: GARAGE E%TERIOR ELEVATIONSfflB�� `A' TrT�Front, Sitles&Back Views 1`/1 1V 1 1835 Resslr Av¢p2 Waynesboro, VA xx980.2/17/20 Pnone swsaxsAxz 18HONES INCORPORATED ?1 ` County of Albemarle ASSESSMENTS UNIT � AlbemarleCountyFinance@albemarle.org FINANCE AND BUDGET DEPARTMENT tel: 434-296-5852 REVENUE ADMINISTRATION DIVSION Monday - Friday: 8 AM - 5 PM 800-828-1120 TTY - Fax: 434-243-7906 2023 NEW BUSINESS LICENSE APPLICATION I STEP 1: DOCUMENTS REQUIRED FOR A NEW BUSINESS LICENSE (SELECT ALL SUBMITTED WITH APPLICATION) Zoning Approval from Community Development Department (Required but does not have to be obtained prior to applying for a Business License) ❑ Social Security Number or Federal Employer ID (FEIN) number (Apply for FEIN at wvvvvurs.gov/small-business) ❑ If Business has a trade name, need a trade name registration with the SCC (www.scc vireinia eov) ❑ If Business is general partnership, limited partnership, corporation, business trust, or limited liability company, need copy of state corporation commission registration (www see vireinia eov) ❑ If Contractor, need a copy of contractor's license from the State Board of Contractors and certificate of liability insurance STEP 2: ENTER START DATE - APPLY WITHIN 30 DAYS FROM START DATE TO AVOID 10% LATE FILING PENALTY DATE BUSINESS BEGAN IN ALBEMARLE COUNTY: 02/01/2023_-(MM/DD/YYYY) ------------ STEP 3: TYPE OF BUSINESS (SELECT ONE) - Individual/Sole Proprietorship = Partnership Corporation LLC =Public Service Corp —Other STEP4: BUSINESS INFORMATION Legal Name: Dippans Properties, LLC Trade Name: Tax Identification Number (FEIN or 92-2085659 SS#): Website: N/A Business Location Address: 5741 St. George Ave. Crozet, VA 22932 MailinL Address: 15739 St. George Ave. Crozet, VA 22932 Contact Name: Jen Diggans Email: Jen.diggans@gmail.com Telephone: (802) 578-1523 STEP 5: BUSINESS ACTIVITY - MUST PROVIDE GROSS RECEIPTS TO DETERMINE BUSINESS LICENSE FEE OR TAX! Provide a brief description of your business: Homestay Grass Receipts mcivaes receipts Tram safes mace, services rendered, or activities conducted from a place of business within the County, includingABC Sales. (ABC sales must be included with total retail or wholesale gross receipts). • IF your gross receipts are $25,000 or less, the business license is waived and there is NO FEE. • IF your gross receipts are greater than $25,000 but less than $100,000, there is a $50 LICENSE FEE -LICENSE FEE DUE WHEN YOU APPLY. • IF your license taxis based on a Flat Tax (see Table 2 below) the TAXIS DUE WHEN YOU APPLY. • IF your gross receipts are $100,000 or more see Table 1 below), the TAXIS DUE JUNE 15 2023 ifan I in after this date the taxis DUE IN 30 DAYS If you began AFTER 1/1/22 and PRIOR to 1/1/23; enter Actual Gross Receipts for 2022 AND estimate 2023 below 2023 Estimated Gross Receipts $ $ If you began on or after 1/1/23; enter Estimated Gross Receipts from your start date thou 12/31/2023 $10,000 LICENSE TAX RATES CALCULATION FOR GROSS RECEIPTS OF $100,000 OR MORE Tax Year Gross Receipts Multi I B Rate Use Table 1 Bebw E uals Business License Fee 2022 Actual Gross Recei is $ X - $ 2023 Estimated Gross Recei is $ X - $ TABLE 1 - LICENSE TAX RATES FOR GROSS RECEIPTS OF $100,000 OR MORE Select bebw El Retailers or Retail Merchants $0.0020 ❑ Wholesalers or Wholesale Merchants $0.0005 ❑ Repair, Personal, Business, and Other Services $0.0036 ❑ Rental of Houses, Apartments, or Commercial Properties $0.0020 El Financial, Real Estate, and Professional Services $0.0058 ❑ Public Service Corporations $0.0050 1-1Contractors, Developers, and or Speculative Builders $0.0016 ❑Utility Company $0.0050 ❑ Vending Machines or Coin Operated Devices (Retail Merchant) $0.0020 ❑ Direct Retail Seller; Telephone, Internet, and/or Mail $0.0010 TABLE 2 - IF YOUR BUSINESS IS ONE OFTHE FOLLOWING, THE BUSINESS LICENSE IS THE FLAT TAX LISTED BELOW (Select below - Coin Operated Devices for Amusement $100 Peddlers, Mobile Food $50 ❑ Fortunetellers, Clairvoyants, etc. $500 ❑ Peddlers, Non -Food $500 ❑ Carnivals and Circuses (For Profit) $500/Day ❑ Bondsmen $150 ❑ Carnivals and Circuses (Not for Profit) $25/Day ❑ Itinerant Merchant, Food $50 ❑ Show and Sale - 7 Day Period $50 ❑ Itinerant Merchant, Non -Food $500 ❑ Show and Sale - 30 Day Period $150 ❑ Building/Savings & Loan Assoc $50 El Show and Sale - 365 Day Period $600 BUSINESS LICENSE FEE ($0, $50, CALCULATED, OR FLAT FEE): 1 $0 CONTINUED ON PAGE 2 -SEE BACK OF FORM FOR STEPS 6-11 401 McIntire Road, Suite 133 1 Charlottesville, VA 22902 STEP 6: VIRGINIA ALCOHOLIC BEVERAGE CONTRil LICENSE(S) - SKIP, IFNOTAPPLICABLE Select all that annly anri Pntpr ARC iron ofe (am Aike......c- r-_.._. Anr-I:---- _r_,.. �, -- _, .r. u e„ nerve Cori monweann or vu ima issue tl ABC license. BEER ONLY: ❑ On Premises ($25) ❑ Off Premises ($25) ❑ On/Off Premises ($50) ❑ Wholesale Beer Distributor ($75) BEER AND WINE: ❑ On Premises ($37.50) ❑ Off Premises ($37.50) ❑ On/Off Premises ($75) MIXED BEVERAGES: ❑ 0-100 Seating ($200) ❑ 101-150 Seating ($350) El 151 or more Seating ($500) WINE INDUSTRY: ❑ Winery License ($50) ❑ Wholesale Wine Distributor ($50) ❑ Farm Winery (No Fee) ❑ Wine Retailer (Gross Receipts) BREWERY: ❑ Produce <500 Barrels (Flat Fee $250) ❑ Produce 500 or more Barrels (Flat Fee $1,000) ❑ Beer Bottler (Flat Fee $500) DISTILLERY: ❑ Produce >5,000 Gallons (Flat Fee $750) Produce >36.000 Gallons (Flat Fee $1,000) = Fruit Distiller (Flat Fee $S00) TOTAL ALBEMARLE COUNTY ABC LICENSE FEES: 8 CTCn �. wnnrr,n� I uvau¢ao etc Nadal - arar. IC NU APPLiCAHLF f CONVENIENCE STORE: �] Sell Prepared Food/Deli; enter actual Gross Receipts for 2022 or estimate 2023 $ ❑ Sell Gasoline, enter actual Gross Receipts for 2022 or estimate 2023 $ ROOM/VENUE RENTAL: ❑ Rent Space, Land or Venue, enter actual Gross Receipts for 2022 or estimate 2023 $ ❑ Rent Rooms for <30 days, enter actual Gross Receipts for 2022 or estimate 2023 $ AUTO DEALERSHIP: ❑ Sell Automotive Parts, enter actual Gross Receipts for 2022 or estimate 2023 $ ❑ Automotive Repair Shop, enter actual Gross Receipts for 2022 or estimate 2023 $ ❑ Auto Wholesale Merchant, enter actual Gross Receipts for 2022 or estimate 2023 $ HOTEL/MOTEL: ❑ Restaurant on -site, enter actual Gross Receipts for 2022 or estimate 2023 $ ❑ Gift Shop on -site, enter actual Gross Receipts for 2022 or estimate 2023 $ ❑ Other Services Offered, enter actual Gross Receipts for 2022 or estimate 2023 $ OTHER - Please describe: 1EActual Gross Receipts for 2022 or Estimate 2023 $ OTHER BUSINESS LICENSE FEE OR TAX BASED ON GROSS RECEIPTS $ ($4 $5Q OR CALCULATED AMOUNT USING THE METHOD FOUND IN STEP 5): ) STEP 8: ARE YOU CLAIMING A VEHICLE(S) FOR BUSINESS USE? It you are claiming a veNcle(s) for business use on your federal income taxes, please provide the details below. A vehicle used more than 50 percent for business ourooses. under the Perannal PrnnPrty Tay PcI;Qf Arf nr rooa (DID-i i, .,,. ;� .-,.a u.. c._. I -._ — —._ _ ,_.. _ _ _ � ... , ---_ YEAR MAKE MODEL ,a.1 a .,., —sv u— u, u x", m, u ... for .... VIN STEP 9: TOTAL AMOUNT DUE TOTAL TAX/FEE DUE FROM STEPS 5, 6 AND 7 $0 ANY LATE FILING OR PAYMENT PENALTIES DUE: $0 (Make Checks Payable to Albemarle County) GRAND TOTAL DUE: $0 10: DECLARATION OF TAXPAYER I declare that the foregoing statements and amounts are true and correct to the best of knowledge and belief. I understand that it is a misdemeanor for any person to willfully subscribe to a return that is not believed to be true and correct as a to every material matter. (Virginia Code 58.1-11) Applicant Signature: ,✓1-- Date: I )' Submit your completed applica ioi nand suppo ng documentation via email to AlbemadeCoun Finance u�albemarle.org, mail to County of Albemarle, 401 McIntire Rd, Suite 133, Charlottesville VA 22902, or Fax to (434)243-7906. Submission of an incomplete application or missing required documentation may result in denial of your application, late filing penalties, and late payment fees. STEP 11: FILE BUSINESS LICENSE APPLICATION Submit your completed application and supporting documentation via email to AlbemarleCountyFinance@albemarle.org, or mail to County of Albemarle, 401 McIntire Rd, Suite 133, Charlottesville VA 22902, or Fax to (434)243-7906. Submission of an incomplete application or missing required documentation may result in denial of your application, late filing penalties, and late payment fees. Contractors must attach a copy of their State Contractor's license, certificate of liability insurance, a schedule showing gross receipts from all sources, and an itemized list of licenses purchased in other localities, including the gross amount on which the license was based. Contractors based outside of Albemarle County should report only gross amounts earned in Albemarle County. Please note the Out-of-County's contractor's taxable threshold is$25,000 annually. Work -from -Home Business operations are subject to business license taxation, regulations, guidelines, and due dates. Real Estate Brokers exclude receipts paid to agents and must provide a list of agents' name, address, and amounts. Wholesale Merchants may substitute gross purchases for gross receipts. Thank you in advance for completing and submitting your business license application and for making your subsequent payment by the stated deadlines) IfI"/Ww*711/1a"I);�i713/��( /./ /.FRO71,: i 6rrt