HomeMy WebLinkAboutHS202300008 Application 2023-02-221 Homestay
Zoning Clearance Application
+^cr r AlbemarteCounty
Y=J1 II 'p Community Development
I. r. 401 McIntire Rd., North Wing
Charlottesville, VA 22902
Phone 434.296.58321 Fax 434.972.4126
Application fee: $173.76
Submit this completed application with the following online or to the address above: Application su9+TerhnuilosrSurcharge $4,76.mspection$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 to + 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 23uest bedrooms by -right Use of occessorystructures (if built before August 7, 2019) is
onlypennittedby-rightonruralareaparcels of5+acres. Whole house rental is onlypermitted on rural area parcels of 5+ acres.
ADDRESS:
11051 Hopkins Court
CITY, STATE, ZIP:
I Charlottesville, VA 22901
TAX MAP PARCEL (IF KNOWN):
I 046A2-03-00-00400
ZONING(IF KNOWN):
I Reside
ADVERTISED NAME OF HOMESTAY (IF APPLICABLE):
ACREAGE OF PARCEL:
0.30
NO. OF GUEST BEDROOMS:
1
USING ACCESSORY STRUCTURES?
YES
NO
WHOLE HOUSE RENTAL?
YES
NO
2. Property Owner/Operator Information
NAME:
Helen Dempsey-Henofer
HOME ADDRESS:
1051 Hopkins Court
CITY, STATE, ZIP:
Charlottesville, VA 22901
PHONE NUMBER:
803-206-4625
1 EMAIL:
helen@00000nandCompany.Inf
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:
Helen Dempsey-Henofer
HOME ADDRESS:
1051 Hopkins Court
CITY, STATE, ZIP:
Charlottesville, VA 22901
PHONE NUMBER:
803-206-4625
EMAIL:
1heleniPcocoonandcompany.infic
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,) also certify that I have read the
restrictions on homestays, that I underAri them td that I will abide bythem.
SIGNATURE: I ql� p /w � f I DATE: I 01/16:2023 1
Fee Amt$169+4% Date Paid:
Receipt N:
Received by:
H S a
FOR OFFICE USE ONLY
Safety inspection date: Pass Fail 2nd inspection date: Pass Fail
VDH Food Service (if necessary):
Notes:
Floorplan
Reviewd By:
Approved
Parking ID
Denied
itial