HomeMy WebLinkAboutHS202100053 Application 2023-03-06February 6, 2023 Page 3
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Short -Term Rental Registry
Annual Application
R.i OF AG#�_ Albemarle County
J2 `�7A Community Development
n 401 McIntire Rd. North Wing
Charlottesville, VA 22902
Phone 434.296.5832
rRmNFP www.albemarle.org
Prior to opening for business, all operators of short-term rentals (including homestays and previously approved bed and breakfasts and
accessory tourist lodging rentals) must:
• Enroll on the Short -Term Rentals Registry with this form
• Obtain an approved zoning clearance (requires VDH and building/fire safety inspection) v✓
• Register for a bgsiness license and remit reouired taxes
Annually following the initial approvals, all operators of short-term rentals must:��}\
• Renew their enrollment on the registrywith thisform ` \C
• Pass a fire safety inspection
• Renew their business license and remit recluired taxes
Fields marked with an 'asterisk are the minimum required for registration.
1. Short -Term Rental Information
A whole house rental is a short term rental of a home during which the owner is not required to be present. Whole house rentals are only permitted on Rural
Area parcels of 5+acres.
OMESTAY (HS), BED AND BREAKFAST (BNB), OR ACCESSORY
GING (ATQ CLEARANCE PERMIT NUMBER (IF APPLICABLE):
Z </Lk Ni/
*TOURISTLODGING
ZIP:
n
/2IGY V �L VA 2 ZCEL
(IF KNOWN):
ZONING IIF KNOWN):
OMS:
WHOLE HOUSE RENTAL-
�ES ❑ NO
2. Property Owner/Operator Information
'NAME:
f fHN
'HOME ADDRESS:
a /N
'CITY, STATE, ZIP:
t4/21_SV LL VA
PHONE:
/ i 2,
EMAIL:
�j i� � q�
tI (Z�DF hWL,4 , to-11,11
3. Responsible Agent Information
The responsible agent must be available within 3,p miles of the homestay at all times during a homestay use, and must respond and attempt in good faith to
resolve any complaints within 6Dminu[ cof being contacted.
OWNER/OPERATOR IS RESPONSIBLE AGENT:
NAME:
HOMEADDRESS:
CITY, STATE, ZIP:
PHONE
FOR OFFICE USE ONLY
❑ NO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
EMAIL:
Date Paid:
Fee Amt: ❑$27 11$0 with clearance application Ck#:
Received by:
❑ Accepted ❑ Denied
Registration Date: _/J_
www.albemarle.org/homestays v. 9.17.20 1 Page 1 of I
February 6, 2023 Page 3
Short -Term Rental Registry
Annual Application
.sy°r" Albemarle County
o2 -m Community Developmemg
� � 401 McIntire Rd. North Win
Charlottesville, VA 22902
Phone 434.296.5832
1%RmNtP www.albemarle.org
Prior to opening for business, all operators of short-term rentals (including homestays and previously approved bed and breakfasts and
accessory tourist lodging rentals) must:
• Enroll on the Short -Term Rentals Registry with this form
• Obtain an approved zoning clearance (requires VDH and building/fire safety inspection)
• Register for a business license and remitreauiredtaxes
Annually following the initial approvals, all operators of short-term rentals must: \
• Renew their enrollment on the registry with this form
• Pass a fire safety inspection
• Renew their business license and remitreauiredtaxes
Fields marked with an'astensk are the minimum required for registration.
1. Short -Term Rental Information
00q��
A whole house rental is a short term rental of a home during which the owner is not required to be present. Whole house rentals are only permitted on Rural
Area parcels of 5+ acres.
'APPROVED HOMESTAY (HS), BED AND BREAKFAST (BNB), OR ACCESSORY
TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER (IF APPLICABLE):
'ADDRESS:
Z V, /_ N
'CTTY,STATE,ZIP:
/2L 5 V �C VA �I z O/ 3
1_ L !mo t
TAXMAPPARCEL(IFKNOWN):
ZONING (IF KNOWN):
GUESTBEDROOMS:
WHOLE HOUSE RENTAL'
W`YES O NO
2. Property Owner/Operator Information
'NAME:
AIl N /f,V'J f2 i06F r F.N�
'HOMEADDRESS:
41A,1
!2 f> ' �r
'CnY,SrATE,ZIP:
64/2I/ SV GG VA
PHONE:
c9 — t / 2 4
EMAIL:
tI Rl DF N L /�/rJ WL f} COH1
3. Responsible Agent Information
The responsible agent must be available within 3P moles 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.
NSIBLE AGENT:
ES ONO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
F
EMAIL -
FOR OFFICE USE ONLY Date Paid:
Fee Amt: 0$27 0$0 with clearance application CkM
Receipt M: Received by:
❑Accepted ❑Denied
Reviewed bv:
Registration Date:
www.albemarle.orgthomestays v. 9.17.201 Page 1 of 1