HomeMy WebLinkAboutATL201800003 Application 2023-03-06February 6, 2023 Page 3
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s: F� Albemarle County
ip Community Development
Short -Term Rental Registry 401 McIntire Rd. North Wing
m Charlottesville, VA 22902
Annual Application ^'F Phone 434.296.5832
r 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:
• Enrol Ion the Short -Term Rentals Registry with this form
• Obtain an approved zoning clearance (requires VDH and building/fire safety inspection) n
• Register for a business license and remit reouired taxes ``^ r�
Annually following the initial approvals, all operators of short-term rentals must: ,'((�j.�\
• Renew their enrollment on the registry with this form"
• Pass a fire safety inspection
• Renew their business license and remit required 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.
"APPROVED HOMESTAY (HS), BED AND BREAKFAST (BNB), OR ACCESSORY
TOURIST LODGING (ATL) CLEARANCE PERMIT NUMBER (IF APPLICABLE):
WTI Zml$-3
'ADDRESS: 923 iZ0 `1 Efl. 'D��iV.ti ,A
"CITY, STATE, ZIP: Cko_r[PLtej�rl{,.te VA 22402
TAX MAP PARCEL (IF KNOWN): '�� _p I _ ((g ZONING (IF KNOWN): PLow-r%toL tk4i t 6ep ei.
pmet
GUESTBEDROOMS: j,{ WHOLE HOUSE RENTAL: OYES XNO
2. Property Owner/Operator Information
*NAME: I . s
-HOMEADDRESS: q23 .)rt;JC.
-CITY, STATE, ZIP: l kar Lot -e SV4 (_Le_ V A ZZ R 0 2 PHONE: 4 7J LJ _O n 2_ _ 10' EMAIL: W l OCP�f CXI f 9 MAi �- r
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 6060 minutes of being contacted.
OWNER/OPERATOR IS RESPONSIBLE AGENT: YES ❑NO IF NO, COMPLETE RESPONSIBLE AGENT INFORMATION BELOW
NAME:
HOMEADDRESS:
CITY, STATE, ZIP:
PHONE: EMAIL:
FOR OFFICE USE ONLY Date Paid: _/--/_ ❑Accepted ❑Denied
Fee Amt: 0$27 13$0 with clearance application Ck#:
Reviewed by:
Receipt #: Received by: Registration Date: _/--/_
www.albemarle.org/homestays v. 9.17.201 Page 1 of 1