HomeMy WebLinkAboutHS202300011 Approval - County 2023-02-20� E)--7 )
Homestay
Zoning Clearance Application
Albemarle County
Community Development
m 401 M<In[ire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296,59321 Fax 434.972.4126
76
Submit this completed application with the followingAppllrvv eU.7ee:E173.Me
�^ia:; or to the address above: rwclRxansttv.nd,,,aaays,.aw s+.>4.inpamontso
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
ResldendolNzoned and rued area Pameh of Am than 5 ours may have 2guest b>hoo i,by-right Use of,,,d,,,,y5mACftWa gfbu& before August 7,2019)e
only POT-Ittrd by -right an nwd arm pamals of 5+ a u to Whole house rerrtd is a* pemdtted an rural area p vcos a f S+alms
RESS:157Rtwnna
FatmSTATE,ZIP:
E
Cturlon®atlle, VA 22911
MAP PARCEL (IF KNOWN}.
0000-00-0 -onoo
ZONING (IF KNOWN):
AbVERTISED NAME OF HOMESfAY(IF APPLICABLE):
Rmue. Parm Bahtes
ACREAGE FPARCEL:
No. OF GUEST BEDROOMS:
5
USINGACCESSOWSTRUCTURES?
❑YES mN0
f WHOLE HOUSERENTAL?
❑YES ONO
2. Property Owner/Operator Intormalion
NAME: Lawrence glanford & Tamar Glaeer `I
i
HOME ADDRESS: 1959 Rivanna Farm
CITY, STATE, ZIP. Chat'lottesWle, VA 22911
PHONE NUMBER: 330.625.67a4 & 310.396.6060 EMAR: bona tgbeer®yahwmm
3. Responsible ASent Information
The rewnslbleagent must be available within 30 miles of the hanwstayata0 timesduno, a hornedaytegandmug mWondandaHanyt 1. gwdfWM to
resdwanymmlaints within 60 minutes of being contacted
NAME Same as above
HOMEADDRESS:
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 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 I will abide by them.
_._.._
SIGNATURE DATE:
Fee Amt$169+4% Date PdW:
Rewipt 0:
Received br
Hsa
FOR OFFICEU/SyE�ON LY
Satetyinspationdate: IC7Ea'1'L/ as ❑FaR 2ndinspechandate: ❑Pass ❑Fail
VDH Food Service Of necessary} _ _ oprplan ID
Revlewd0r. /
Date:
PProved ____—ODenied___.__
,PP�01lED
')y 'he Albemarle County
.ornmunity Development Department
Date