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Application for
Class A Home Occupation Clearance
Home Occu ation Class A Clearance = $27.00
Horne Occupation, Class A: An occupation, not expressly prohibited by section 5.2, conducted for profit within a dwelling
unit solely by one or more members of the family residing within the dwelling unit; provided that nothing herein prohibits the
occupation from engaging other persons who work off -site and do not come to the dwelling unit to engage in the occupation.
Name or Business: /J`` CSS Mks Viyz
Type or Business: TI S 1" V1I.Y 1
Tax map and parcel: b 55O D I Q D— D
Zoning: 'F_ 1
Contact Person (Who should we call write concerning this projects?): J C f S I (A- Wes
-
Address A28 1 j2tfJ,ro( - Aws Ck City I V6 zed- state�" /�VA Zip 27 Z
Daytime Phone (�4 i71Y 5 — b I Z[ Fax # L� E-mail ) CSS'MI I(S fll'V�Cf S 0 Gi r11G11 I
Owner of Record )1 a&
Address 225uu8 �AYvDyj heaAJVo 1 (Ptq '�°ity C ax i o tics A I ll e- state jV _ Zip ZZ610 3
Daytime Phone -13 I - 76 Fax # (_) E-mail � 6ku i1'D K 0 Y1 &
This certificate, in conjunction with a business license, represents zoning approval to conduct the Class A Home Occupation
identified above. Each home occupation is subject to the following:
PLEASE CHECK EACH BOX SO THAT IT IS CLEAR THAT YOU HAVE READ
L"J LOCATION&AREA (DhC bt6lwovVn / q I X 11 t
The home occupation shall be conducted entirely within the dwelling unit, provided that not more than twenty-five
(25) percent of the gross floor area of the dwelling unit shall be used for the home occupation and further provided
that the gross floor area used for the home occupation shall not exceed one thousand five hundred (1500) square feet.
[Section 5.2 (b) 1)]
1 EXTERIOR APPEARANCE
There shall be no change in the exterior appearance of a dwelling unit or other visible evidence of the conduct of a
home occupation. [Section 5.2 (c) 1)]
12 SALES
No home occupation shall sell goods to a customer who comes to the site except for goods that are hand-crafted on -
site and goods sold that are directly related to a beauty shop or a one -chair barber shop home occupation.
[Section 5.2 (d)]
County of Albemarle Department of Community Development
401 McIntire Road Charlottesville, VA 22902 Voice: (434) 296-5832 Fax: (434) 9724126
I Ilt2ol5 Page I orz
Ea/TRAFFIC
The traffic generated by a home occupation shall not exceed the volume that would normally be expected by a
.,/dwelling unit in a residential neighborhood. [Section 5.2 (e)l
LSD PARKING
All vehicles used in a home occupation and all vehicles of customers, clients or students shall be parked on -site.
[Section 5.2 (f)l
0PERFORMANCE STANDARDS
The home occupation shall comply with the performance standards in section 4.14. [Section 5.2A (k)[
Does the use involve procedures, machinery or chemicals that may cause the following?
NOISE
VIBRATION
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
RADIOACTIVITY
ELECTRICAL DISTURBANCE
NON -DOMESTIC WASTE DISCHARGED TO A SEPTIC FIELD OR SEWER
�If YES, then applicable standards must be addressed with a Certified Engineer's Report (available from staff).
11'J PROHIBITED USES
The following uses are expressly prohibited as home occupations: (1) tourist lodging; (2) nursing homes; (3) nursery
schools; (4) day care centers; and (5) private schools. [Section 5.2 (h)[
WAIVERS AND MODIFICATIONS: The above standards are eligible for waiver or modification by the Planning
Commission. Ask staff for more information about applicable fees and process. [Section 35 and Section 5.11
Owner/Applicant Must Read and Sign
I hereby apply for approval to conduct the Home Occupation identified above, and certify that this address is my legal
residence. I also certify that I have read the restrictions on Home Occupations, that I understand them, and that I will abide
by them.
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rgnature of Owner/Applicant Date
jtssico. S NAdcs 434'3(oS--6121
Print Nam _ Daytime phone number of Signatory
7`
Review to
ENGINEER'S REPORT ATTACHED: YES NO
CONDITIONS: I,.6m( 6(�ICe We I /b f bO�!V)L ZUDVVI %eS/Sle✓1S
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1V12015 Pagc2of2
Albemarle County
Zoning Clearance Application `401 MUnun WM."Rd. Nwth'
A U9 WMN
Che�dlesvi0e, VYL02
Ph. 4�.M-5532
Applicant - If you are not the landowner, please fill out the entire page below, confirming that you have either
informed or are going to notify the owner of your application.
CERTIFICATION THAT NOTICE OF THE APPLICATION HAS BEEN
PROVIDED TO THE LANDOWNER
I certify that I will provide (or have provided) notice of this clearance application,
Class F� RDVW 0((UPMibV1 O(O—KOVl(c, �✓ Jfss Miies
171 his s
to SOC '?6V•CA,-, Rf)a 0 �y UL the owner
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of Tax Map and Parcel Number ytao D S 5-0 0 - Db - DD 'by either delivering a
copy of the application to them in person or by sending them a copy of the application by
mail. (Please check one of the following below)
❑ Hand delivering a copy of the application to the owner identified above on
Date
Mailing �a"copy of the application to the owner identified above on
Date to the following address:
�SP, Avvt�Wl k tra lac �j yi /C�)aVlo-Hesv1 I1c , VA 42,gQ,
(Written notice to the owner and last known address on our record books will satisfy this
requirement. Please see staff for help determining this information if needed)
Signature of Applicant
Applicant Name Printed J a Sl C6. 5 M H—lfs
Date b " N — U 21