HomeMy WebLinkAboutHO201200028 Legacy Document 2012-07-13Application for�,.,'y�
JiI 01/
Class A Home Occupation Clearance
❑ Home Occupation Class A Clearance = $25.00
F-1 Certification that notice of this application has been provided to the property owner, if owner is different
from applicant.
Hone 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 of Business:
Type of Business: j7 () K.2 r
Tax map and parcel: JW `06 - 62— Zoning:
Contact Person (Who should we call/write
concerning this project?): 1 (,h ei CJ?dhD
Address fe rn )CO �"J
State�d1/#'// Y;� __ Zip 22
Daytime Phone 2D2 - ZI 2 $� Fax # U E-mail p�.i [ elie c naa r n%(- 7
Owner of Record IVI1 a l;tke. L) Y d 4 fn
Address Z 6 6 % fe rn ka2C 116l City GJ1d,r Id ffCS V!'1( e- State V A Zip 2291 f
Daytime Phone 15J-' 202 - Z )2q Fax # ( )
E-mail Widle-de-Ctomboo-17o—%1Gtr nq
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 AND
,_,/ UNDERSTAND THE REQUIREMENTS FOR THIS CLEARANCE
Ld LOCATION & AREA
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)]
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)]
LSI(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) 972-4126
7/1/2011 Page I of
FOR OFFICE USE ONLY
HO#
Dr) Date Paid 2
Fee Amount $ a5
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By who? 1 l I G� ICA �P f5fiReceipt # 86VVJ_Ck4
1 ( ( By:�
Application for�,.,'y�
JiI 01/
Class A Home Occupation Clearance
❑ Home Occupation Class A Clearance = $25.00
F-1 Certification that notice of this application has been provided to the property owner, if owner is different
from applicant.
Hone 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 of Business:
Type of Business: j7 () K.2 r
Tax map and parcel: JW `06 - 62— Zoning:
Contact Person (Who should we call/write
concerning this project?): 1 (,h ei CJ?dhD
Address fe rn )CO �"J
State�d1/#'// Y;� __ Zip 22
Daytime Phone 2D2 - ZI 2 $� Fax # U E-mail p�.i [ elie c naa r n%(- 7
Owner of Record IVI1 a l;tke. L) Y d 4 fn
Address Z 6 6 % fe rn ka2C 116l City GJ1d,r Id ffCS V!'1( e- State V A Zip 2291 f
Daytime Phone 15J-' 202 - Z )2q Fax # ( )
E-mail Widle-de-Ctomboo-17o—%1Gtr nq
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 AND
,_,/ UNDERSTAND THE REQUIREMENTS FOR THIS CLEARANCE
Ld LOCATION & AREA
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)]
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)]
LSI(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) 972-4126
7/1/2011 Page I of
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)]
M(PARKING
All vehicles used in a home occupation and all vehicles of customers, clients or students shall be parked on-site.
[Section 5.2 (i)]
lJ PERFORMANCE 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?
If YES, then applicable standards must be addressed with a Certified Engineer's Report (available from staff).
Ed 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 5.1]
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.
Signature of Owner/Applicant
JV11C,h C 11C (' ol17r1c r I212
Print Name
Reviewer
ENGINEER'S REPORT ATTACHED: YES NO
CONDITIONS:
Date
i - l Z
Da
2-0
Daytime phone number of Signatory
Z_�//2&/7
Date
7/1/2011 Page 2 oft
YES NO
NOISE
X
VIBRATION
X
GLARE
HEAT
AIR POLLUTION
WATER POLLUTION
X
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).
Ed 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 5.1]
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.
Signature of Owner/Applicant
JV11C,h C 11C (' ol17r1c r I212
Print Name
Reviewer
ENGINEER'S REPORT ATTACHED: YES NO
CONDITIONS:
Date
i - l Z
Da
2-0
Daytime phone number of Signatory
Z_�//2&/7
Date
7/1/2011 Page 2 oft
y
CERTIFICATION THAT NOTICE OFPE
APPL CATION HAS BEEN PROVIDED TO THY LANDOWNER
This form st accompany zoning applications (Home Occupation, Zoni Clearance, Zoning
Administrato Determinations or Appeals, Sign Permits, Building Perm's) if the application is not the
owner.
I certify thaNpotice of the application,
was provided to _
[name(s)f the record owners of the
and Parcel Number
manner identified below:
Hand delivering a copy of t e appli
person; if the owner of record i an
title or office for that entity]
on
Date
Mailing a copy of the
if the owner of record
office for that entity]
on
Date
to
[County pplication name and number]
the owner of record of Tax Map
]
by delivering a copy of the application in the
'to
[Name of the record owner if the record owner is a
identify the recipient of the record and the recipient's
[Na of the record owner if the record owner is a person;
entity, identify t e recipient of the record and the recipient's title or
to the foll)owin2 address:
[address; written notice mailed to the owner at the las known address of the owner as shown on
the current real estate tax assessment books or current'eal estate tax assessment records satisfies
this requirement].
Signature of
Print Applicant
Date