HomeMy WebLinkAboutHS202300003 Approval - County 2023-04-12Homestay
Zoning Clearance Application
Albemarle County
a Community Development
-j-- ` 401 McIntire Rd., North Wing
Charlottesville, VA 22902
rrm:ct` Phone 434.296.58321 Fax 434.972,4126
Submit this completed application with the following walineortothe address above: Application $u9.TerIDwlpityysuocnargesq>see+lnw ionsso
I. 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
Residentially zoned and rural area parcels of less than 5 acres may have 2 guest bedrooms by -right. Use of accessary built before August 7, 2019) is
structures (if onlypermitted by -right on rural area parcels of 5+acres. Whole house rental is only permittedon rural area parcels of 5+acres,
ADDRESS: .l 'S� `N V'n QC� �..�,hf✓ — __- _...
CITY STATE. 21P:
TAX MAP PARCEL (IF KNOWNk y �—� '— -- -----
ZONING (IF KNOWN)
LADVERTISED NAME OF HOMES (AY (IF APPLICABLY:
ACREAGE OF PARCEL
NO. OF GUEST BEDROOMS: USING ACCESSORY STRUCTURES? ❑YLS - -
-------- _J ❑V;i f WHOLE HOUSE RENTAL?L: ❑•ir
2. Property Owner/Operator Information
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t HOME ADDRES4 1 ; �e��.
CITY, STATE ZIP:--
-= e 'V �r off— a�lal
PHONE NUMBER L-`1 L-�/-O`'1'i t EMAIL - —�- -- 1 L we �J�.J _..
3. Responsible Agent Information
The responsible agent must be available within 30 miles of the homesal?at at/ times during a homestayuse, and must respond and attemptingood f It to
resolve any complaints within 60 minutes of being contacted.
NAME' 't.i--l�'i1 • rC..!?i.C� __ _ _ .._.
HOMEADDRESS: (.-�<1 �•`�Qr ` - --
CITY STATE. ZIP. r-ba.
PHONE NUMBER: LAM EMAIL.
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CO,'YN
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 or that 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. __ _...
- --- _ _.. I DATE
Fee Amt $169. 4% Date Paid:
Receipt 9: _.
Received by
HSa
FOR OFFICE USE ONLY
Safety Inspecbae date: ass ❑ Fail
VDH Food Service If necessary):
Notes: _
2nd inspection date: ❑ Pass ❑ Fai
o Floprplan arking AID
Reviewd By, "Za� Z34i,&.._
Date: y� 2oz3
pproved Denied