Short Term Rental - Bedford County Page 3
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3CERTIFICATION
The undersigned hereby certifies the reading and understanding of all of the regulations stated in Section
30-100-18 Short-term Rentals of the Bedford County Zoning Ordinance and that the dwelling unit and
property for which application is being made is and will continue to remain fully compliant with these
regulations (listed above).
Printed Name of Owner(s) __________________________________________________________________
Signature of Owner(s) _____________________________________________________________________
Date ________________________________________________________
Printed Name of Rental Agency representative _________________________________________________
Signature of Rental Agency representative _____________________________________________________
Date _________________________________________________________
Applications for properties managed by a rental agency must be signed by the rental agency before
submission to Bedford County.
OFFICE USE ONLY
_____
Application
______ Septic Permit
______ Fee
Date Received:
______________________________
Received by: ________________________________
Date entered in system: ________________________
Entered by: _________________________________
Project #: ___________________________________
Zoning Use Approval #: ______________________
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122 EAST MAIN STREET, SUITE G-03, BEDFORD, VA 24523 (540) 586-7616, FAX (540) 586-2059
Effective 07/01/2013
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