HomeMy WebLinkAboutATL201400003 Application 2015-04-23Each
FOR OFFICE USE ONLY ATL #
Pee Amount Date Paid NABy who? A 1& ), jo- Receipt Il CU IMI By:�
Application for ar``
Tourist Lod!ina
500rourist Lodging fee = $100
214Tourist Lodging Regulations Checklist.
F-1 Certification that notice of this application has been provided to the property owner,
if owner is different from applicant.
A Tourist Lodging is a use within a residential zoning district composed of transient lodging provided within a single family
dwelling having not more than five (5) guest rooms, located where the single family dwelling is actually used as such and the guest
rooms are secondary to the single-family use, whether or not the guest rooms are used in conjunction with other portions of the
Project Natne:
Massey-Kildea
Tax map and parcel: 062A2 00 OC 01700 Zoning: R2 residential
Physical Street Address (if assigned): 2613 Huntington Road, Charlottesville, VA 22901
Location of property (landmarks, intersections, or other):
Contact Person (Who should we call/write concerning this project?):
2613 Huntin ton Road
Kathy Kildea or Roy Massey
Charlottesville
Address g City
State VA zip 22901
Daytime Phone
43 531-3957 Fax#(434 817-2199 E-mail kmkildea@gmail.com
owner of Record Delbert R. Massey and Kathleen M. Kildea
Address same as above City State Zip
Daytime Phone (_)
Applicant (Who is the Contact person representing?):
Address
Daytime Phone (_)
Fax # (_) E-mail
Same as above
City State Zip
Fax # (_) E-mail
Owner/Applicant Must Read and Sign
I hereby certify that the information provided on this application and accompanying information is accurate, true and correct to the best of
my knowledge and belief.
Signature of Owner, Agent 7 Date
Print Name Daytime phone number of Signatory
Conditio !��%�/LE�/V• r/l LDF
Zoning --
County of AlbemarISDb'di ittiWeWiYPJPCommunity Development
401 McIntire. Road t1N1P1��f3T��/�tQ�l M64) 296-5832 Fax: (434) 972-4126
CommuniY1117,
Dment Department Revised 6/22/2012 Page 1 oft
Date l
File#
igna re
CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This _form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application,
Application for Tourist Lodging
[County application name and number]
was provided to Delbert R. Massey and Kathleen Kildea the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number _
manner identified below
062A2 -00 -OC -01700
by delivering a copy of the application in the
X Hand delivering a copy of the application to Delbert R. Massey and Kathleen Kildea
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the recipient of the record and the recipient's
title or office for that entity]
on 10/1/14
Date
Mailing a copy of the application to
[Name of the record owner if the record owner is a person;
if the owner of record is an. entity, identify the recipient of the record and the recipient's title or
office for that entity]
on
Date
to the following address:
[address; written notice mailed to the owner at the last known address of the owner as shown on
the current real estate tax assessment books or current real estate tax assessment records satisfies
this requirement].
Signature of Applicant
mw�>-
Print Applicant Name
10- 1:A4
Date